Format

Send to

Choose Destination
Surg Today. 2019 Jun;49(6):513-520. doi: 10.1007/s00595-019-1773-9. Epub 2019 Jan 31.

Life-threatening complications after pulmonary resection for lung cancer in patients on chronic hemodialysis.

Author information

1
Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, 589-8511, Japan.
2
Department of Thoracic Surgery, Izumi City General Hospital, Izumi, Osaka, Japan.
3
Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama, 589-8511, Japan. mitsudom@med.kindai.ac.jp.

Abstract

PURPOSE:

The morbidity and mortality associated with lung cancer surgery in patients on chronic hemodialysis (CHD) is high; however, the relationship between the severity of postoperative complications and clinicopathological features is unclear.

METHODS:

Among 1214 consecutive patients who underwent pulmonary resection for primary lung cancer in our institute between 2004 and 2015, we identified 21 patients on CHD, who were the subjects of this study. Life-threatening postoperative complications were defined as grade 4 and 5 per the Clavien-Dindo classification.

RESULTS:

Fourteen (67%) of these 21 patients suffered postoperative complications, which were life threatening in 5. There was a higher frequency of interstitial pneumonia (IP) in the patients with life-threatening postoperative complications than in those with complications that were not life threatening (pā€‰=ā€‰0.032). The rates of acute exacerbation and 90-day mortality in the patients with IP were 50% and 75%, respectively. The overall survival (OS) rate of the patients with life-threatening postoperative complications was significantly lower than that of those with complications that were not life threatening (1- and 3-year OS rates: 40% and 0% vs. 80% and 57%, respectively, pā€‰=ā€‰0.001).

CONCLUSIONS:

Postoperative mortality and morbidity were high in patients on CHD who underwent pulmonary resection, especially if they had coexisting IP. Although IP is not a contraindication to pulmonary resection, the surgical strategy for CHD patients with IP should be considered carefully.

KEYWORDS:

Chronic hemodialysis; Interstitial pneumonia; Lung cancer

PMID:
30706240
DOI:
10.1007/s00595-019-1773-9
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center