O-172 Postoperative mortality after lung cancer surgery. A population-basedstudy

Due to the high lung cancer morbidity and the need for surgical intervention in that patient population, introduction of the concept of standard protocol for enhanced recovery after surgery (ERAS) may lead to a significant decrease of the rate of postoperative complications and hospital stay. The aim of the review was to assess the main components of ERAS protocol in thoracic cancer surgery using video-assisted thoracoscopic interventions (VATS). Systematic implementation of specific measures in pre- (patient consulting before the intervention, compliance with fluid and nutrition regimen, exclusion of routine sedation, prophylaxis of venous thrombosis, use of intravenous antibiotics and alcohol skin-prepping solution with chlorohexidine), intra- (prevention of hypothermia, thoracoscopic approach, single-tube approach in anatomic lung resections, exclusion of pleural tube insertion, urethral catheterization for less than 2 hours and only in case of epidural anesthesia) and postoperative (early mobilization and cessation of intravenous infusion, pain control using combination of acetaminophen with NSAIDs, maintenance of normovolemy, use of balanced crystalloid solutions and non-pharmacological measures for nausea and vomiting control) periods promote improved outcomes, decrease of postoperative complication rate and postoperative mortality

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Postoperative Mortality Following Lung Cancer Surgery

Heart Lung and Circulation ◽

10.1016/j.hlc.2013.10.004 ◽

2014 ◽

Vol 23 (1) ◽

pp. e27

Author(s):

Shoni Colquist ◽

Hazel Harden ◽

Dannie Zarate ◽

Tracey Guan ◽

Morgan Windsor ◽

...

Keyword(s):

Lung Cancer ◽

Lung Cancer Surgery ◽

Postoperative Mortality ◽

Cancer Surgery

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Does liver cirrhosis have any impact on patients with lung cancer after surgical resection?

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz126 ◽

2019 ◽

Vol 29 (4) ◽

pp. 551-554

Author(s):

Han-Yu Deng ◽

Liang Hou ◽

Panpan Zha ◽

Qinghua Zhou

Keyword(s):

Lung Cancer ◽

Liver Cirrhosis ◽

Cohort Studies ◽

Surgical Resection ◽

Lung Cancer Surgery ◽

Postoperative Mortality ◽

Cancer Surgery ◽

Term Survival ◽

Study Type

Summary A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: does cirrhosis have any impact on patients with lung cancer after surgical resection? Altogether, 134 papers were found using the reported search, of which 6 cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Five of the cohort studies found that liver cirrhosis was correlated to higher postoperative mortality after lung cancer surgery, 4 also showed a correlation with higher postoperative morbidity and 2 of them found that patients with Child grade B or above experienced a higher risk of morbidity and mortality than those with Child grade A. Four of the cohort studies found that cirrhotic patients had poorer long-term survival, with 2 studies showing patients with Child grade B or above having a worse overall survival than those with Child grade A. Therefore, we conclude that liver cirrhosis (especially Child grade B or above) imposed a significant unfavourable impact on both short-term and long-term outcomes for patients intended for lung cancer surgery.

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