OBJECTIVE: The purpose of the present study is to identify the currentpostoperative complications after a pulmonary resection for primary lungcancer and the associated risk factors. METHODS: From 1988 to 1992, 291patients with primary lung cancer, excluding T4 diseases, consecutivelyunderwent a pulmonary resection at our institute. The observedpostoperative complications were divided into non-life- threatening ones(simple arrhythmia, atelectasis, liver dysfunction, etc.) andlife-threatening ones (respiratory failure, pyothorax, pneumonia,bronchopleural fistula, cardiac failure, cerebral infarction, myocardialinfarction, etc.). Using logistic regression procedures, both univariateand multivariate analyses of the association between various perioperativefactors and the incidence of postoperative complications were performed.RESULTS: Non-life- threatening complications occurred in 60 patients(20.6%) while life- threatening ones occurred in 36 (12.4%), and resultedin five in- hospital deaths (1.75%). Multivariate analyses showed that anage of 70 or older, a combined resection, an abnormality on preoperativeECG, and diffusing capacity of carbon monoxide (%DLco) below 70 were allindependently associated with an increased non-life-threatening morbidity.On the other hand, an age of 70 or older, the need for a pneumonectomy, anda %DLco below 70 were also independently predominant risk factors forlife-threatening morbidity. CONCLUSION: The risk factors forlife-threatening morbidity therefore did not completely correspond to thosefor non-life-threatening morbidity. Since the mortality was quite low, evenrisk factors for life-threatening morbidity were not solely considered tobe a contraindication for a major pulmonary resection.