Predicting pulmonary complications after pneumonectomy for lung cancer

Algar, Francisco Javier Algar; Álvarez, Antonio; Salvatierra, A.; Baamonde, C.; Aranda, José Luis; López–Pujol, Francisco Javier

doi:10.1016/s1010-7940(02)00719-4

Cited by 140 publications

(97 citation statements)

References 21 publications

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“…The variety and incidence of postoperative complications after pneumonectomy have been examined in a number of studies, all of which reported that acute respiratory failure was the most common, [9][10][11] but, whether preoperative FEV 1 and FEV 1 /FVC, and predicted postoperative FEV 1 are independent risk factors remains unclear. 11,12) In our study, however, we excluded pneumonectomy from the analysis of postoperative complications since the number of pneumonectomy was too small to perform multivariate logistic regression analysis.…”

Section: Discussionmentioning

confidence: 99%

Impact of Airflow Limitation on Comorbidities and Postoperative Complications in Patients Undergoing Thoracic Surgery: A Retrospective Observational Study

Yoshimi

Suzuki

et al. 2016

ATCS

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41). Airflow limitation was also an independent risk factor for postoperative respiratory failure including long-term oxygen therapy (OR 2.14) and atelectasis (OR 1.90) in the patients who underwent lobectomy or partial resection of the lung. Conclusions: Our retrospective study revealed that careful attention needs to be paid to airflow limitation in patients who undergo non-cardiac thoracic surgery since it appears to be an important feature of preoperative comorbidities and to increase postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Impact of Airflow Limitation on Comorbidities and Postoperative Complications in Patients Undergoing Thoracic Surgery: A Retrospective Observational Study

Yoshimi

Suzuki

et al. 2016

ATCS

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“…Lung cancer is the most common cause of cancer-related deaths worldwide (1). Surgical resection offers the best part in the treatment for lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Identifying patients at higher risk of pneumonia after lung resection

et al. 2017

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Background: Pneumonia is considered as one of the most common and serious complications after lung resection. The purpose of this study was to identify the risk factors associated with postoperative pneumonia (POP) after lung resection and to develop a scoring system to stratify patients with increased risk of POP.Methods: A retrospective review of a prospective database of patients between September 2014 and June 2016 was carried out. Logistic regression analysis was used to examine the risk factors for POP. Bootstrap resampling analysis was used for internal validation. Regression coefficients were used to develop weighted risk scores for POP.Results: Results revealed that age ≥64 years, smoking (current or previous), high pathological stage, and extent of excision of more than one lobe as risk factors. Logistic regression analysis showed that the predictors of POP were as follows: age ≥64 years, smoking, extent of excision of more than one lobe.A weighted score based on these factors was developed which was follows: smoking (three points), age ≥64 years (four points), and extent of excision of more than one lobe (five points). POP score >5 points offered the best combination of sensitivity (64.7%) and specificity (83.3%), and an area under receiver operating characteristic (ROC) curve ( Conclusions: Patients with older age, smoking and extent of excision of more than one lobe have a higher risk for pneumonia after lung cancer surgery. Also, the scoring system helps to guide decision making of POP risk reduction.

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“…Poor pulmonary function parametersare strongly correlated with increased postoperative morbidity and mortality [1,[25][26][27]. In prospective studies, even with good pulmonary function the mortality rate for major lung resection was 2.7% -4% and morbidity rate was up to 41%.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly the group with reduced lung capacity bordering on inoperability was the target group of our investigation. No single parameter for operative risk prediction exists, but there are several recommendations [4,25,34]. Severe reduction of FEV 1 was the main inclusion criterion for our study.…”

Section: Discussionmentioning

confidence: 99%

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Non-Invasive Pressure Support Ventilation in Major Lung Resection for High Risk Patients: Does It Matter?

Danner

Koerber²,

Emmert³

et al. 2012

OJTS

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Background and purpose: Patients with severely impaired pulmonary function have an increased operative risk for major lung resection. The clinical benefits of pre-and perioperative, non-invasive pressure support ventilation (NIPSV) have up to now not been extensively evaluated. Patients with severely reduced pulmonary function were investigated in this prospective and randomised single centre clinical trial. Methods: Standard pulmonary evaluation was performed in all patients before major lung resection. To predict postoperative pulmonary function, a lung perfusion-ventilation scan was carried out. All patients enrolled in the study were instructed preoperatively on how to use a NIPSV respirator. After lung resection patients were randomised either for continuation of NIPSV or for standard treatment. Results: Of the 52 patients assessed, 21 patients met the inclusion criteria for the study protocol. Predicted mean postoperative FEV 1 was 1.10 L (range 0.92 -1.27 L). Lobectomy was performed in 14 patients, pneumonectomy in 6 patients and a segmentectomy in 1 patient. No inhospital deaths occurred. Pulmonary complications (reintubation, pneumonia) were more frequent in the NIPSV group than in the control group (3 patients versus 1 patient), without statistical significance (p = 0.31). Conclusions: We observed no mortality and a low morbidity in this high risk group. Postoperative continuation of NIPSV had no beneficial effect on the clinical outcome. Preoperative conditioning with NIPSV, however, seems to be a suitable tool for patients with severely impaired pulmonary function. This study may serve therefore as basis for further investigations for the potential clinical benefits of prophylactic NIPSV in major lung surgery.

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Predicting pulmonary complications after pneumonectomy for lung cancer

Cited by 140 publications

References 21 publications

Impact of Airflow Limitation on Comorbidities and Postoperative Complications in Patients Undergoing Thoracic Surgery: A Retrospective Observational Study

Impact of Airflow Limitation on Comorbidities and Postoperative Complications in Patients Undergoing Thoracic Surgery: A Retrospective Observational Study

Identifying patients at higher risk of pneumonia after lung resection

Non-Invasive Pressure Support Ventilation in Major Lung Resection for High Risk Patients: Does It Matter?

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