Bleeding is the most common cause of unplanned return to operating room after lung cancer surgeries

BACKGROUND: The rate of unplanned return to the operation room (UROR) is an important index for the quality of surgeries. Study of the features and causes of patients who have suffered UROR is key to reduce the risk of it. METHODS: A retrospective, observational study was conducted among lung cancer patients who have received lung resections and UROR over a 5-year period. The causes, findings, procedures of UROR and recovery of patients were examined. RESULTS: Among the 23,345 lung cancer surgeries, 64 underwent UROR with the rate being 0.27%. Lobectomy was performed in 78.1% of the patients. The most common indication was post-operative bleeding, responsible for 82.8% (53/64) of the cases. The median length of stay after the second surgery was 7 days and over 90% of the patients were discharged with proper recovery. The death rate within 90 days after return to operation room (OR) was 1.6% (1/64). In the 53 cases caused by bleeding, 27 (50.9%) occurred in surgical sites, with the raw surface of lymph node dissection being most frequently affected. Bleedings on incisions and unknown origin took up 11.3% and 37.7%, respectively. CONCLUSIONS: Bleeding is the most common indication which causes over 80% of UROR for lung cancer surgeries. Careful examination and complete hemostasis in surgery is key to reduce the risk of this unwanted complication.