Cirugía resectiva pulmonar en pacientes en el límite funcional

Izquierdo, J.M.; Pac, J.; Casanova, J.; Vara, Francisca Cerdá; Cortés, Javier; Fombellida, J.; Gáldiz, Juan B.

doi:10.1016/s0300-2896(15)30897-8

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Moreover, patients who had a long history of smoking might accompanied with a decreased pulmonary function, and smoking history would reduce the compensatory ability of cardiac pulmonary function after surgery and further increase the risk of arrhythmia (27). Also, pulmonary capillary bed reduction and insufficiency of pulmonary ventilation function after lung resection would result in decreasing of lung ventilation/perfusion ratio and increasing of pulmonary capillary blood flow (28). Cardiac function would also significantly be reduced (29).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

Gao

et al. 2017

J. Thorac. Dis.

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Background: Postoperative cardiopulmonary complications might be fatal for patients with lung cancer after surgery. The aim of this study was to identify the risk factors of postoperative cardiopulmonary complications in lung cancer patients and get a fitting formula for predicting incidences of cardiopulmonary complications. Methods:We conducted a retrospective analysis of 653 patients with a diagnosis of lung cancer who underwent a surgery in the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) from January to December 2014. All patients received lung cancer surgeries. Clinical data was collected for the analysis of the influence factors of cardiopulmonary complication after lung cancer surgeries. The medical statistical analysis program R was used to calculate cardiopulmonary complication probability of classification of quantitative results.Results: Our work showed that ages, lymphocyte count, smoking history, chronic bronchitis history, operation mode and extubation time were significantly associated with lung infection both in univariate and multivariate survival analysis. And ages, smoking history, arrhythmia of electrocardiogram and operation mode were significantly associated with postoperative arrhythmia both in univariate and multivariate survival analysis. Multiple linear regressions were generated with risk factors by program R software. Finally, we got a fitting formula for predicting cardiopulmonary complications. Risk score for each patient could be obtained by this formula. Conclusions:The incidences of pulmonary infection and arrhythmia were high for patients who underwent lung cancer surgery. It is important to discriminate risk factors for each patient for reducing the risk of heart and lung complications. Preoperative quantitative evaluation of cardiopulmonary complication after operation is beneficial to the risk control.

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Section: Discussionmentioning

confidence: 99%

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

Gao

et al. 2017

J. Thorac. Dis.

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“…It shows a [6,9,11,13]. This method could be made more precise by incorporating tomographic imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, many patients who could benefit from resection surgery show poor functional values that go against an indication for this surgery. In these cases other assessments are needed, such as perfusion or ventilation pulmonary scintigraphy, which are the most frequently used methods, as they provide a regional assessment of lung function and can be used to estimate postoperative pulmonary function, using the predicted postoperative FEV1 (FEV1,ppo) [5][6][7][8][9][10][11][12][13]. Operative risks in patients with FEV1,ppo 0.8-1.0 L or w40% FEV1 pred are acceptable for indicating lung resection for both pneumonectomy and lobectomy [14][15][16].…”

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confidence: 99%

The use of SPECT in preoperative assessment of patients with lung cancer

Piai¹,

Quagliatto²,

Toro³

et al. 2004

Eur Respir J

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Perfusion scintigraphy is the most frequently used method for the regional assessment of pulmonary function in candidates for pulmonary resection with borderline respiratory function. This method provides two-dimensional images, and it considers all the segments of the pulmonary lobes as having the same volume and function, without considering the spatial overlapping of pulmonary areas with different function. As single-photon emission computed tomography (SPECT) provides tomographic imaging, this could be a more precise method for regional assessment.In this study, the postoperative predicted forced expiratory volume in one second (FEV1) (FEV1,ppo) was calculated in 26 patients with lung cancer using FEV1, quantitative lung perfusion scan with planar acquisition (PA) and quantitative lung perfusion scan with tomographic imaging (SPECT).The estimated FEV1,ppo values obtained using both methods were compared with FEV1 values measured after surgery (mean: 48¡44 days; range: 15-180 days; median: 32 days). The Pearson9s linear correlation coefficient was 0.8840 for FEV1,ppo estimated by PA and 0.8791 for FEV1,ppo estimated by SPECT. The linear correlation coefficient for lobectomy was greater than the coefficient for pneumonectomy using both methods.In conclusion, both methods show good correlation for real postoperative pulmonary function without demonstrating single-photon emission computed tomography superiority over planar acquisition, and both methods were more effective for estimating postoperative predicted forced expiratory volume in one second in lobectomies than in pneumonectomies. Eur Respir J 2004; 24: 258-262. Surgical resection is the treatment of choice for nonsmall cell lung cancer, and this therapy should be encouraged, as the prognosis worsens for patients who are not operated on. However, the removal of the lung parenchyma in patients, the majority of whom are smokers, and who have compromised cardiovascular and lung conditions, may cause deterioration in ventilatory function and lead to cardiopulmonary failure or death. Therefore, in these patients, a preoperative assessment is extremely important before the appropriate therapy is chosen [1][2][3][4].Pneumonectomy is well tolerated by the patient if: the forced expiratory volume in one second (FEV1) is either o2 L or w60% FEV1 predicted; the maximal voluntary ventilation (MVV) is w50% pred; the residual volume/total lung capacity ratio is either v0.5 or the carbon monoxide diffusion capacity of the lung is w60%. Lobectomy is well tolerated by the patient if: the FEV1 is o1 L and if the MVV is o40% pred. Nevertheless, many patients who could benefit from resection surgery show poor functional values that go against an indication for this surgery. In these cases other assessments are needed, such as perfusion or ventilation pulmonary scintigraphy, which are the most frequently used methods, as they provide a regional assessment of lung function and can be used to estimate postoperative pulmonary function, using the predicted postoperative...

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