Pneumonectomy was associated with significantly higher activation of coagulation system on the seventh postoperative day than lobectomy. TAT complex, TF and E-selectin are promising markers of extensive postoperative activation of coagulation and efficacy of antithrombotic prophylaxis.
IntroductionThe surgical treatment of non-small cell lung cancer (NSCLC) with synchronous brain matastases is more effective than other therapeutic options, but this management is still controversial.The aim of the studyThe aim of the study was to evaluate the survival of patients after pulmonary resection NSCLC preceded by resection of brain metastases.Material and methodsFrom 2007 to 2012, 645 patients underwent pulmonary resection for NSCLC at our department. In 25 of them (3.87%) thoracic surgery was preceded by resection of a single brain metastasis of NSCLC and a PET CT scan. No signs of nodal involvement or distant metastases were detected.ResultsThe group consisted of 18 men (72%) and 7 women (28%). Average age was 57.62 years (46-70). In all cases, whole brain radiotherapy (5 × 4 Gy) was performed. The average interval between excision of brain metastasis and lung resection was 31.4 days (27-41). Pneumonectomy was performed in 1, lobectomy/bilobectomy in 17 and wedge resection in 7 cases. Pathological stage N0 was diagnosed in 17, N1 in 5 and N2 in 3 patients. Average survival was 18.68 months (4-74). Survival at 1, 2 and 5 years was 64%, 28% and 28% respectively. Average disease-free survival was 17.52 months. Histological type (p = 0.57) and G (p = 0.82) have no influence on survival. All the patients with hilar lymph node involvement died within 26 months and with mediastinal one within 12 months.ConclusionsSurgical treatment of patients with NSCLC with synchronous brain metastases may prove beneficial in selected patients after excluding other distant metastases and lymph node involvement.
Introduction: Infections are a part of the natural course of lung cancer but few studies have looked at the clinical and microbiological documentation of infections in these patients. The aim of this study is to analyze the profile of potentially pathogenic bacteria that colonize the bronchial tree in patients with primary lung cancer. Material and Methods: The study was conducted from January 2006 to August 2007. It included 44 consecutive patients (34 males and 10 females) with primary lung cancer aged from 38 to 77 (mean age of 57.9 years). In all patients, bronchoalveolar lavage (BAL) was performed during bronchofiberoscopy. Obtained BAL fluid was subjected to microbiological examination. The number of bacteria present in 1 ml of fluid was estimated by quantitative culture. A diagnostic level was set on ≥ 104 cfu/ml. Results: In 26 (59.1%) of 44 patients physiologic bacterial flora was found in the bronchial tree. In three cases (6.8%), potentially pathological bacteria were cultured but their number was < 104 cfu/ml. In 15 (34.1%) cases, the colonization of potentially pathogenic bacteria was ≥ 104 cfu/ml. Both Gram-positive and Gram-negative bacteria were isolated. The most frequently isolated bacterium in the first group was Streptococcus pneumoniae (n = 7), and in the second group Haemophilus influenzae (n = 3). Multibacterial colonization was found in five patients (11.4%). In four cases (9.1%), the bronchial tree was colonized simultaneously by two and in one case [2.3%] by three types of micro-organism. Multi-drug-resistant strains were not found in the examined materials but among Streptococcus pneumoniae the constitutive MLSB phenotype was observed. Conclusions: 1. Approximately 30% of patients with lung cancer had a respiratory tract colonized by micro-organisms whose number was higher than the assumed diagnostic level. 2. Among micro-organisms colonizing the lower respiratory tract, Gram-positive cocci such as Streptococcus pneumoniae and Staphylococcus aureus were dominant. 3. The analysis of antibiotic-resistance did not detect multi-drug-resistant micro-organisms but some strains of Streptococcus pneumoniae exhibited resistance to macrolide, lincosamide and streptogramin B.
The aim of the study was to investigate the influence of bacterial colonisation of a neoplastic lung tumour on the frequency of infectious complications after radical surgical treatment of the malignancy. Material and methods. 49 patients operated on for non-small cell lung cancer (NSCLC) from 23 rd January to 2 nd November 2006 were included into the study. The analyzed group consisted of 39 men and 10 women, they were from 45 to 79 years old. Material for microbiological tests was collected in an operating theatre under sterile conditions directly after the resection of a tumour. A sample (5x5x5 mm) of the tumour was cultured for facultative anaerobes, obligate anaerobes and fungi. After the homogenisation of tumour tissues quantitative culture was also performed. Results. Potentially pathogenic microbes were cultured from tumours in 14 patients (28.6%). The most frequent bacterium was Propionibacterium acnes. It was found in six out of 49 tumours (12.2%). In 13 cases (26.6%) postoperative infectious complications were observed. They were as follows: infection of the lower airways -8 cases (16.3%), surgical wound infection -3 cases (6.1%), pleurisy -1 case (2%) and pleural empyema -1 case (2%). In 12 patients (24.5%) pathogenic microbes were isolated from biological material obtained from other sources than a tumour. In remaining 36 patients (73.5%) no infectious postoperative complications were observed. In 13 patients in whom bacteria were cultured from a tumour there were no postoperative infectious complications. Only in one patient the same bacterium (Staphylococcus aureus) was identified in a tumour and 35 days later in pleural effusion where four other pathogenic bacteria were isolated, too. In 12 patients whose postoperative course was complicated by infections had no pathogenic microbes cultured from a resected tumour. Statistical analysis showed no significant relations between the presence of pathogenic microbes within a lung malignant tumour and postoperative infectious complications in patients. Conclusions. The most frequent microbe cultured from non-small cell lung carcinoma is Propionibacterium acnes. There is no relation between the colonisation of a malignant tumour by bacteria and postoperative complications in patients treated surgically for NSCLC.
Objectives: Final results of prospective randomized study to assess the influence of Tachosil® applied on mediastinum after systematic lymphadenectomy are presented. Material and methods: In 28 patients from the Tachosil® group 1 to 3 large pieces of Tachosil® (mean 1.8, SD±0.7) were applied, while in 22 patient from the control group only coagulation was allowed. Clinical data were collected, and pleural concentrations of IL-6, IL-1ra and IL-8 on postoperative days 1, 2 and 3 were measured, with ELISA method. Results: Both groups were well balanced according to sex, age, number of packyears of cigarettes, time from smoking cessation, pulmonary function test results, concomitant diseases, BMI index, number of N1 and N2 nodes resected, and perioperative serum concentrations of IL-6, IL-1ra and L-8. Postoperative complications occurred in 8/29 and 12/24 patients from each group (p=0.046), respectively, with no mortality. No differences in time of surgery, intraoperative blood loss, amount of drainage and drainage hemoglobin concentration on postoperative days 1, 2 and 3, time to drainage removal and number of blood units transfused between the groups were observed. The summarized postoperative pleural drainage was lower in the Tachosil® group (p=0.03). Concentration of IL-6 in pleural drainage was higher in the Tachosil® group on the first (p=0.01) and the second (p=0.03) postoperative days. Positive correlation between number of blood units transfused and pleural concentration of hemoglobin on subsequent postoperative days in the whole group but not in Tachosil® group was found. Conclusions: This study showed a significant impact of application of Tachosil® on mediastinum after systematic lymphadenectomy on clinical outcome due to decreased amount of total postoperative drainage and decreased rate of complications. A higher concentration of IL-6 in pleural fluid on postoperative day 1 and 2 may reflect a minor local immune response to Tachosil®, without elevation of concentration of other cytokines and without negative impact on postoperative complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.