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The Journal of Cardiovascular Surgery 2002 April;43(2):263-7

language: English

Bronchopleural fistula after lung cancer surgery. Multi-variate analysis of risk factors

Suzuki M., Otsuji M., Baba M., Saitoh Y., Iizasa T., Shibuya K., Sekine Y., Yoshida S., Fujisawa T.

From the Depart­ment of Tho­racic Sur­gery, Grad­uate ­School of Med­i­cine, ­Chiba Uni­ver­sity, Chuo-ku, ­Chiba, ­Japan


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Back­ground. To elu­ci­date ret­ro­spec­tively the ­risk fac­tors for bron­cho­pleural fis­tulae ­after ­lung ­cancer sur­gery.
­Methods. The sub­jects ­were 1,177 ­patients ­with ­lung ­cancer who under­went sur­gery ­between 1983 and 1997. ­Twenty-two clin­ical fac­tors ­were exam­ined by ­logistic anal­ysis.
­Results. Bron­cho­pleural fis­tulae ­were ­observed in 35 ­patients (32 ­males, 3 ­females) ­with a ­mean age of 64 ­years. ­Eighteen (51%) of 35 ­patients ­died of BPF-­related com­pli­ca­tions. The sig­nif­i­cant ­risk fac­tors ­obtained by uni­var­iate anal­ysis ­were ­male ­gender, ­heavy ­smoking, cur­rent ­smoking, low ­level of %FVC, metas­tases to ­lymph ­nodes, squa­mous ­cell car­ci­noma, ­increased WBC, ­decreased ­albumin, ­advanced post­sur­gical ­stage, ­sleeve lobec­tomy, and resec­tion of the ­right ­lower ­lobe or ­middle and ­lower ­lobe. The sig­nif­i­cant ­risk fac­tors ­noted by mul­ti­var­iate anal­ysis ­were ­heavy ­smoking (30 or ­more ­pack/­years), cur­rent ­rather ­than ­past ­smoking, metas­tases to ­lymph ­nodes, ­decreased ­albumin (3.5 mg/dl or ­less), and resec­tion of the ­right ­lower ­lobe or ­middle and ­lower ­lobe.
Con­clu­sions. The ­above ­risk fac­tors ­must be ­taken ­into ­account ­before sur­gical tech­niques fol­lowed by ade­quate per­i­op­er­a­tive man­age­ment are ­selected.

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