Selection of pulmonary resection procedures to reduce postoperative complications in 200 patients

Nagamatsu, Yoshinori; Iwasaki, Yasunori; Kashihara, Masaki; Nishi, Tatsuya; Yoshiyama, Koichi; Yamana, Hideaki; Shirouzu, Kazuo

doi:10.1007/s00595-010-4350-9

Cited by 8 publications

(5 citation statements)

References 25 publications

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“…This was possibly because the proportion of patients undergoing pneumonectomy was very small, or because pneumonectomy was not done in patients who were predicted to suffer a signifi cant decrease in exercise capacity according to the selection criteria employed at our hospital. 4 In addition to the invasiveness of the primary surgery, we also found that performance of mediastinal lymph node dissection infl uenced the early restoration of exercise capacity after surgery. In this series, mediastinal lymph node dissection was selected according to the criteria for surgery employed at our hospital and a battery of preoperative cardiopulmonary function tests.…”

Section: Discussionmentioning

confidence: 66%

“…In this series, mediastinal lymph node dissection was selected according to the criteria for surgery employed at our hospital and a battery of preoperative cardiopulmonary function tests. 4 Mediastinal lymph node dissection is thought to have no signifi cant impact on lung function after lung cancer surgery, and is used only to determine the surgical stage. However, the role of lymph node dissection in early postoperative restoration of exercise capacity is still being investigated in the ongoing ACOSOGZ0030 trial.…”

Section: Discussionmentioning

confidence: 99%

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Factors related to an early restoration of exercise capacity after major lung resection

et al. 2011

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Factors related to an early restoration of exercise capacity after major lung resection

et al. 2011

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“…Pulmonary complications are the most frequent morbidities associated with resection for NSCLC and are associated with a poor prognosis. A range of clinical attributes have been investigated as predictors of individual risk 2 3 7 11 12 . However, there is a need for biomarkers that can enhance prediction and identify those at high risk of post-operative pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

Genetic variation in the TNF/TRAF2/ASK1/p38 kinase signaling pathway as markers for postoperative pulmonary complications in lung cancer patients

Hildebrandt

Roth

Vaporciyan

et al. 2015

Sci Rep

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Post-operative pulmonary complications are the most common morbidity associated with lung resection in non-small cell lung cancer (NSCLC) patients. The TNF/TRAF2/ASK1/p38 kinase pathway is activated by stress stimuli and inflammatory signals. We hypothesized that genetic polymorphisms within this pathway may contribute to risk of complications. In this case-only study, we genotyped 173 germline genetic variants in a discovery population of 264 NSCLC patients who underwent a lobectomy followed by genotyping of the top variants in a replication population of 264 patients. Complications data was obtained from a prospective database at MD Anderson. MAP2K4:rs12452497 was significantly associated with a decreased risk in both phases, resulting in a 40% reduction in the pooled population (95% CI:0.43–0.83, P = 0.0018). In total, seven variants were significant for risk in the pooled analysis. Gene-based analysis supported the involvement of TRAF2, MAP2K4, and MAP3K5 as mediating complications risk and a highly significant trend was identified between the number of risk genotypes and complications risk (P = 1.63 × 10−8). An inverse relationship was observed between association with clinical outcomes and complications for two variants. These results implicate the TNF/TRAF2/ASK1/p38 kinase pathway in modulating risk of pulmonary complications following lobectomy and may be useful biomarkers to identify patients at high risk.

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“…Selection of the surgical procedure for lobectomy was done after performing a battery of preoperative cardiopulmonary function tests in accordance with the Institutional Criteria for Objective Determination of Pulmonary Resection Procedures [3]. Patients who were found to have severe adhesions during thoracotomy and those in whom a diagnosis of lung cancer could not be established preoperatively were excluded because rapid collection of pulmonary venous blood during thoracotomy was impossible.…”

Section: Methodsmentioning

confidence: 99%

“…We have obtained a favourable outcome in our patients by selecting a safe pulmonary resection procedure through a battery of preoperative cardiopulmonary function tests [2,3]. Nonetheless, it remains impossible to completely avoid death after lung cancer surgery.…”

Section: Introductionmentioning

confidence: 97%

Neutrophil elastase activity in pulmonary venous blood during lung resection

Nagamatsu

Iwasaki

Omura

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES: Neutrophil elastase has been reported to play an important role in acute lung injury, which is a major cause of postoperative mortality after pulmonary resection. Neutrophil elastase released in the lungs reaches the peripheral circulation via the pulmonary veins. This study was performed to compare neutrophil elastase activity in pulmonary venous blood (collected during lobectomy) with that in the peripheral blood, and to determine the perioperative changes of neutrophil elastase activity. METHODS:In 34 patients undergoing lobectomy with mediastinal lymph node dissection, the leucocyte count, neutrophil count, neutrophil elastase activity and levels of tumour necrosis factor-α, interleukin-6 and interleukin-8 were measured in the pulmonary venous blood and peripheral arterial blood before and after surgery. Then, these parameters were compared between before and after surgery with peripheral and pulmonary blood.RESULTS: Neutrophil elastase activity was found to be significantly higher in pulmonary venous blood at the completion of surgery than at the start (during thoracotomy), while the neutrophil elastase activity of peripheral arterial blood showed no significant change between the start and completion of surgery. CONCLUSIONS:In conclusion, measurement of neutrophil elastase activity in pulmonary venous blood revealed changes associated with lobectomy.

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Selection of pulmonary resection procedures to reduce postoperative complications in 200 patients

Abstract: The use of five preoperative parameters to select the pulmonary resection procedure minimized postoperative death and major complications.

Cited by 8 publications

References 25 publications

Factors related to an early restoration of exercise capacity after major lung resection

Factors related to an early restoration of exercise capacity after major lung resection

Genetic variation in the TNF/TRAF2/ASK1/p38 kinase signaling pathway as markers for postoperative pulmonary complications in lung cancer patients

Neutrophil elastase activity in pulmonary venous blood during lung resection

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