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Sublobar resection or lobectomy and postoperative respiratory complications in emphysematous lungs.
Miura, Kentaro; Ide, Shogo; Minamisawa, Masatoshi; Mishima, Shuji; Matsuoka, Shunichiro; Eguchi, Takashi; Hamanaka, Kazutoshi; Shimizu, Kimihiro.
Afiliación
  • Miura K; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
  • Ide S; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
  • Minamisawa M; Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
  • Mishima S; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
  • Matsuoka S; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
  • Eguchi T; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
  • Hamanaka K; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
  • Shimizu K; Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Eur J Cardiothorac Surg ; 65(3)2024 Mar 01.
Article en En | MEDLINE | ID: mdl-38447190
ABSTRACT

OBJECTIVES:

Pulmonary resection in patients with severe emphysema may impact postoperative respiratory complications. Low-attenuation areas evaluated using three-dimensional computed tomography to assess emphysematous changes are strongly associated with postoperative respiratory complications. Herein, we investigated the relationship between low-attenuation area, the surgical procedure and resected lung volume, which has not been explored in previous studies.

METHODS:

We retrospectively evaluated patients with primary or metastatic lung cancer who underwent surgical resection. The low-attenuation area percentage (low-attenuation area/total lung area × 100) and resected lung volume were calculated using three-dimensional computed tomography software, and the relationship with postoperative respiratory complications was analysed.

RESULTS:

Postoperative respiratory complications occurred in 66 patients (17%) in the total cohort (n = 383). We set the median value of 1.1% as the cut-off value for low-attenuation area percentage to predict postoperative respiratory complications, which occurred in 24% and 10% of patients with low-attenuation area >1.1% and <1.1%, respectively (P < 0.001). Postoperative respiratory complications occurred in approximately one-third of the patients with low-attenuation area >1.1%, whose resected lung volume was ≥15.8% or ≥5 resected subsegments. Multivariable analysis revealed that sublobar resection was associated with a significantly lower risk of postoperative respiratory complications in patients with low-attenuation area >1.1% (odds ratio 0.4, 95% confidence interval 0.183-0.875).

CONCLUSIONS:

Emphysema is a risk factor for postoperative respiratory complications, and lobectomy is an independent predictive risk factor. Preserving more lung parenchyma may yield better short-term prognoses in patients with emphysematous lungs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfisema Pulmonar / Trastornos Respiratorios / Enfisema / Neoplasias Pulmonares Límite: Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfisema Pulmonar / Trastornos Respiratorios / Enfisema / Neoplasias Pulmonares Límite: Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania