Objective: to evaluate the influence of surgical factors on the rate and degree of postoperative atrial fibrillation (PAF) during lung cancer surgery. Material and methods. Medical records of 532 patients operated on for predominantly Stages II—III malignant lung tumors were retrospectively analyzed to estimate the rate of PAF in relation to an anesthetic management technique (multimodal general anesthesia, mixed anesthesia), an approach (thoracoscopy, thoracotomy), the volume and peculiarities of an intervention (lobectomy, pneumonectomy, and intrapericardial manipulations), the time of surgery, perioperative transfusion therapy. Results. The rate of PAF was 11.7% (62/532). During video-assisted surgery, the rate of PAF was found to be lower than that via thoracotomy access [1.6 (1/60) versus 12.9% (61/472), respectively (p=0.01)]. During pneumonectomy and lobectomy, paroxysmal PAF occurred in 17.6% (25/142) and 9.5% (37/390), respectively (p=0.01). During pneumonectomy with intraoperative pericardial opening or resection, the rate of PAF was 32.4% (12/37), which proved to be significantly higher than that during pneumonectomy without intrapericardial manipulations [12.4% (12/105), (p=0.005)]. During lobectomy with intrapericardial manipulations and without pericardial opening or resection, the rate of PAF was 25.5% (12/47) and 7.3 (25/343), respectively (p=0.001). Perioperative transfusion therapy was performed in 15.9% (85/532). In this group, the frequency of PAF episodes was higher and accounted for 20% (23/85%) versus 8.7% (39/447) in the patients who did not need any blood transfusion (p=0.01). In the continuous thoracic epidural analgesia group, the rate of PAF was significantly lower than that in the general anesthesia group [7.9% (15/190) and 13.7% (47/342), respectively (p=0.04)]. The intensive care unit (ICU) length of stay for PAF patients was significantly higher and amounted to 34±6.4 versus 18.5±4.2 hours in the patients without this complication (p=0.02). Conclusion. Atrial fibrillation complicates the postoperative period during expanded lung cancer surgery and increases ICU length of stay. However, measures to reduce or modify risk factors for PAF should be implemented to reduce this complication.
