Tüdőlebeny-eltávolítást követő kemoterápia tolerabilitását befolyásoló perioperatív tényezők

2018 ◽  
Vol 159 (19) ◽  
pp. 748-755 ◽  
Author(s):  
Aurél Ottlakán ◽  
Balázs Pécsy ◽  
Edit Csada ◽  
Gábor Ádám ◽  
Anikó Maráz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Performance Status ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Postoperative Chemotherapy ◽  
Air Leak ◽  
Vats Lobectomy ◽  
Postoperative Fever ◽  
Prolonged Air Leak ◽  
Duration Of Surgery

Abstract: Introduction: Lung cancer is the leading cause of malignancy-related deaths in Hungary, involving complex surgical and oncological treatment. Aim: Factors influencing the tolerability of complete/planned and incomplete postoperative chemotherapy after surgery were analyzed. Method: During a 6-year period (January 1, 2011–December 31, 2016), data of 72 patients operated with lung cancer (adenocarcinoma and squamous cell carcinoma), receiving complete (4 cycles) and incomplete (<4 cycles) postoperative chemotherapy were analyzed. The following factors among the two groups [complete: n = 53; incomplete: n = 19] were analyzed: gender, mean age, body mass index, Malnutrition Universal Screening Tool, Charlson Comorbidity Index, second malignant tumor, atrial fibrillation, Forced Expiratory Volume 1 sec, Performance Status, open/Video-Assisted Thoracic Surgery (VATS) lobectomy, duration of surgery, postoperative fever, need for transfusion, prolonged air leak, redo surgery, histology, tumor stage. Results: The rate of complete postoperative cycles obtained from logistic regression analysis, were substantially higher after VATS lobectomies [n = 26 (83.87%)] compared to open procedures [n = 27 (65.85%)]; (p = 0.092; OR = 0.356), without significance. Multivariate analysis (open/VATS lobectomy, upper/middle-lower lobe resection, diabetes, prolonged air leak, postoperative fever) showed significantly increased successful uptake of complete cycles after VATS (p = 0.0495), while upper/middle lobe resections (p = 0.0678) and the lack of diabetes (p = 0.0971) notably increased the number of complete cycles, without significance. Conclusion: Twenty-six percent of patients were unable to receive complete planned postoperative chemotherapy. VATS lobectomy patients received significantly higher number of complete cycles of postoperative chemotherapy. Diabetes and lower lobe lobectomies had a negative effect on the tolerability of postoperative chemotherapy. Orv Hetil. 2018; 159(19): 748–755.

scholarly journals A Prolonged Air Leak Score for Lung Cancer Resection: An Analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database

2019 ◽  
Vol 108 (5) ◽  
pp. 1478-1483 ◽  
Author(s):  
Christopher W. Seder ◽  
Sanjib Basu ◽  
Timothy Ramsay ◽  
Gaetano Rocco ◽  
Shanda Blackmon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Air Leak ◽  
Cancer Resection ◽  
Prolonged Air Leak ◽  
General Thoracic Surgery

Right Lower Lobectomy With Middle Lobe Preservation After Right Upper Lobectomy in Lung Cancer of the Right Lower Lobe

2013 ◽  
Vol 96 (6) ◽  
pp. 2227-2230 ◽  
Author(s):  
Naohiro Taira ◽  
Tsutomu Kawabata ◽  
Atsushi Gabe ◽  
Takaharu Ichi ◽  
Kazuaki Kushi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Lower Lobectomy ◽  
The Right ◽  
Middle Lobe Preservation ◽  
Right Lower Lobectomy

Prolonged air leak following lobectomy can be predicted in lung cancer patients

Surgery Today ◽  
2017 ◽  
Vol 47 (8) ◽  
pp. 973-979 ◽  
Author(s):  
Satoru Okada ◽  
Junichi Shimada ◽  
Daishiro Kato ◽  
Hiroaki Tsunezuka ◽  
Masayoshi Inoue
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Air Leak ◽  
Lung Cancer Patients ◽  
Prolonged Air Leak

Upper and Middle Lobe Atelectasis

Chest Imaging ◽  
2019 ◽  
pp. 93-97
Author(s):  
Christopher M. Walker
Keyword(s):  
Lung Cancer ◽  
Main Bronchus ◽  
Lower Lobe ◽  
Outpatient Setting ◽  
Middle Lobe ◽  
Inpatient Setting ◽  
Central Mass ◽  
Contrast Enhanced Ct ◽  
Left Hemidiaphragm ◽  
Contrast Enhanced

Upper and middle lobe atelectasis discusses the radiographic and computed tomography (CT) manifestations of upper and middle lobe atelectasis. The most common radiographic signs of right upper lobe atelectasis include upward and medial displacement of the minor fissure, superior displacement of adjacent structures such as the hilum and main bronchus, and ipsilateral shift of the mediastinal structures. The S sign of Golden results from a centrally obstructing lung cancer as the cause of the atelectasis and manifests as a reverse S configuration of the minor fissure outlined by atelectatic lung and central mass. Left upper lobe atelectasis manifests with a veil-like opacity on frontal radiography with leftward shift of upper mediastinal structures such as the trachea and upward shift of the left main bronchus and left hemidiaphragm. The Luftsichel sign or air crescent sign may be seen and represents the hyperexpanded superior segment of the left lower lobe outlining the transverse aortic arch. Lobar atelectasis in the inpatient setting is most commonly secondary to an obstructing mucus plug. Lobar atelectasis in the outpatient setting is often a heralding sign of a centrally obstructing lung cancer and should be further evaluated with contrast-enhanced CT and/or bronchoscopy.

scholarly journals Lung function tests, exercise capacity and postoperative outcomes of patients with pulmonary resections

Pneumologia ◽  
2021 ◽  
Vol 69 (3) ◽  
pp. 159-165
Author(s):  
Irina Pele ◽  
Ciprian Bolca ◽  
Ștefan Dumitrache-Rujinski ◽  
Florin Mihălțan
Keyword(s):  
Lung Cancer ◽  
Respiratory Failure ◽  
Lung Function ◽  
Exercise Test ◽  
Postoperative Outcomes ◽  
Air Leak ◽  
Respiratory Complications ◽  
Significant Difference ◽  
Prolonged Air Leak ◽  
Postoperative Atelectasis

Abstract Aim: Postoperative complications, especially pulmonary complications, are described after lung resections, with different risk factors involved. We evaluate the relationship between lung function, exercise test parameters and the occurrence of postoperative outcomes in patients with pulmonary resections. Methods: A 5 years prospective observational study on patients with lung resection (lobectomy, bilobectomy and pneumonectomy) for lung cancer and other pulmonary pathologies has been performed. All the patients were preoperatively evaluated using spirometry, plethysmography, diffusing capacity test and cardio-pulmonary exercise test (CPET). Data were analysed regarding the linkage between cardiopulmonary fitness and postoperative outcomes (respiratory complications and 90-day mortality). Results: Of 155 consecutive patients (109 male, mean age 61.2 ± 9.8 years), 130 (83.9%) underwent pulmonary resection for lung cancer. Nearly 24% of patients developed postoperative respiratory complications (mainly atelectasis, prolonged air leak and respiratory failure). The 90-day mortality was 5.2%. A reduced absolute value of forced expiratory volume in 1 s (FEV1) was found to be associated with postoperative atelectasis [odds ratio (OR) 0.33; 95% confidence interval (CI) 0.11–0.99], but with low accuracy. The most related variable and a predictor to prolonged air leak was FEV1/vital capacity (VC) ratio (OR 0.90; 95% CI 0.83–0.99). Patients who developed respiratory failure had lower values of static volumes and breathing reserve (BR%) compared to those without respiratory failure, but with no significant difference (P > 0.050). No relationship to mortality was noted. Conclusion: In our study group, lower values of FEV1 were related to postoperative atelectasis and obstructive dysfunction with persistent air leak, with no significant association with mortality.

Involvement of the #12u Lymph Nodes Around the Upper Lobe Bronchi in Patients with Lung Cancer of the Right Middle Lobe, Right Lower Lobe, or Left Lower Lobe

Surgery Today ◽  
1999 ◽  
Vol 29 (3) ◽  
pp. 238-242
Author(s):  
Masami Sato ◽  
Yasuki Saito ◽  
Hirokazu Aikawa ◽  
Akira Sakurada ◽  
Tatsuo Tanita ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Left Lower Lobe ◽  
Right Middle Lobe ◽  
The Right

scholarly journals PROLONGED AIR LEAK AFTER LOBECTOMY IN LUNG CANCER PATIENTS

2020 ◽  
Vol 19 (1) ◽  
pp. 103-110
Author(s):  
E. A. Toneev ◽  
D. V. Bazarov ◽  
O. V. Pikin ◽  
A. L. Charyshkin ◽  
A. A. Martynov ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Air Leak ◽  
Lung Cancer Patients ◽  
Prolonged Air Leak

Video-Assisted Thoracic Surgery Lobectomy: Report of CALGB 39802—A Prospective, Multi-Institution Feasibility Study

2007 ◽  
Vol 25 (31) ◽  
pp. 4993-4997 ◽  
Author(s):  
Scott J. Swanson ◽  
James E. Herndon ◽  
Thomas A. D'Amico ◽  
Todd L. Demmy ◽  
Robert J. McKenna ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Mediastinal Lymph Node ◽  
Performance Status ◽  
Vats Lobectomy ◽  
Technical Feasibility ◽  
Lung Cancers ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
N2 Disease

Purpose To evaluate the technical feasibility and safety of video-assisted thoracic surgery (VATS) lobectomy for small lung cancers. Patients and Methods The Cancer and Leukemia Group B 39802 trial was a prospective, multi-institutional study designed to elucidate the technical feasibility of VATS in early non–small-cell lung cancer (NSCLC) using a standard definition for VATS lobectomy (one 4- to 8-cm access and two 0.5-cm port incisions) that mandated videoscopic guidance and a traditional hilar dissection without rib spreading. Between 1998 and 2001, 128 patients with peripheral lung nodules ≤ 3 cm in size with suspected NSCLC were prospectively registered for VATS lobectomy. Results One hundred twenty-seven patients (66 males and 61 females; median age, 66 years; range, 37 to 86 years), with a performance status of 0 (74%) or 1 (26%), underwent surgery. Patients with lymph nodes more than 1 cm by computed tomography scan underwent mediastinal lymph node sampling to rule out N2 disease. One hundred eleven patients (87%) had stage I lung cancer, and 96 (86.5%) of these 111 patients underwent successful VATS lobectomies. The median procedure length was 130 minutes (range, 47 to 428 minutes), and median chest tube duration was 3 days (range, 1 to 14 days). Fifty-eight (60%) of 97 patients underwent diagnostic biopsy at lobectomy. Within 30 days, three (2.7%) of 111 patient deaths occurred, none of which were directly related to VATS technique; seven (7.4%) of 95 patients had grade 3 or greater complications, with only one case of bleeding. Conclusion A standardized approach to VATS lobectomy as specifically defined with avoidance of rib spreading is feasible.

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