ORIGINAL ARTICLES  THORACIC SECTION 

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

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.