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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2001 Febbraio;42(1):125-9

lingua: Inglese

Experience with fatal interstitial pneumonia after operation for lung cancer

Tanita T., Chida M. *, Hoshikawa Y. *, Handa M. *, Sato M., Sagawa M., Ono S., Matsumura Y., Kondo T., Fujimura S.

From the Department of Thoracic Surgery Institute of Development, Aging and Cancer Tohoku University, Sendai, Japan
*Department of Surgery, Sendai Kousei Hospital, Sendai, Japan


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Background. The num­ber of ­patients ­with ­lung can­cer is increas­ing. This ­study was under­tak­en to real­ize the prob­abil­ity, ­fate and man­age­ment of ­acute ­fatal post­op­er­a­tive com­pli­ca­tions. Since inter­sti­tial pneu­mo­nia was one of the ­most ­fatal post­op­er­a­tive com­pli­ca­tions, to ­know its inci­dence and ­fate is ­very impor­tant.
Methods. A ­total of 2667 ­patients who under­went thor­a­cot­o­my ­caused by malig­nant ­tumors dur­ing the ­past 17 ­years ­were ­reviewed and stud­ied. We per­formed inves­ti­ga­tions on med­i­cal ­records, ­chest X-­rays, ­whole-­body CT ­films, oper­a­tive ­records and path­o­log­i­cal spec­i­mens for all inpa­tients.
Results. Nineteen ­patients ­died in hos­pi­tal 30 ­days ­after thor­a­cot­o­my (oper­a­tive ­death). Nine ­patients ­died in hos­pi­tal ­more ­than 31 ­days ­after thor­a­cot­o­my (hos­pi­tal ­death). Eight cas­es out of 28 ­patients (oper­a­tive and hos­pi­tal ­deaths) devel­oped and final­ly ­died by inter­sti­tial pneu­mo­nia. Each ­case was treat­ed ­with ster­oids, neu­troph­il-elas­tase inhib­i­tor, and/or immu­no­sup­pres­sive ­agents. These ­patients ­could not be select­ed by any pre­op­er­a­tive labor­a­to­ry exam­ina­tion, ­such as pre­op­er­a­tive pul­mo­nary func­tion ­tests, ser­um bio­chem­is­try ­tests, and ­chest X-ray or CT ­films. Interstitial pneu­mo­nia as a com­pli­ca­tion of post­op­er­a­tive ­stage, was ­fatal and ­once devel­oped, it was ­very dif­fi­cult to ­save ­their ­lives.
Conclusions. Since we report­ed the cas­es who ­died from a­cute post­op­er­a­tive com­pli­ca­tions, espe­cial­ly inter­sti­tial pneu­mo­nia, we ­could not ­present effec­tive man­age­ment. However, in ­this ­report, sev­er­al ther­a­peu­tic ­trials ­that may ­solve the prob­lems of ­acute post­op­er­a­tive inter­sti­tial pneu­mo­nia ­were pro­posed.

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