Fylgikvillar blaðnámsaðgerða við lungnakrabbameini á Íslandi 1999-2008

Skúladóttir, Rut; Óskarsdóttir, Guðrún; Ísaksson, Helgi J.; Jónsson, Steinn; Þorsteinsson, Húnbogi; Guðbjartsson, Tómas

doi:10.17992/lbl.2010.04.284

Cited by 3 publications

(11 citation statements)

References 16 publications

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“…3 , Tómas Guðbjartsson laeknir 1,4 (ground glass opacity) á tölvusneiðmynd (tS), en slík aexli vaxa sjaldan ífarandi. 10 á síðustu tveimur árum hafa birst í Laeknablaðinu tvaer greinar um árangur blaðnáms hér á landi 11,12 og ein um árangur lungnabrottnáms við lungnakrabbameini ÖES. 13 árangur fleyg-og geiraskurða hefur hins vegar ekki verið rannsakaður sérstaklega og var markmið þessarar rannsóknar að kanna árangur þessara aðgerða hér á landi.…”

Section: Inngangurunclassified

“…Fjórir fengu geislameðferð eftir aðgerð, tveir vegna þess að eitlar sem teknir voru við aðgerð reyndust innihalda meinvörp og tveir vegna vaxtar í skurðbrún. Einn sjúklingur hafði fengið lyfjameðferð [11][12] Marktaekur munur reyndist á hlutfalli tilfella á stigi i, meðalstaerð aexla, aðgerðartíma og blaeðingu í aðgerð, fleygog geiraskurðum í hag. Hlutfall sjúklinga með kransaeðasjúkdóm reyndist hins vegar marktaekt laegra hjá sjúklingum sem fóru í blaðnám.…”

Section: Niðurstöðurunclassified

“…Þessi rannsókn sýnir að fimm ára lífshorfur eftir fleyg-eða geiraskurð á Íslandi eru góðar (40,9%) og nokkuð sambaerilegar við árangur eftir blaðnám (45,1%). 11,12 tíðni skurðdauða og alvarlegra fylgikvilla eftir fleyg-og geiraskurði er lág og ekki reyndist marktaekur munur á þessum þáttum borið saman við fyrrgreindu rannsóknirnar á blaðnámi. 11,12 Skurðdauði var enginn í báðum rannsóknum, sem verður að teljast góður árangur.…”

Section: Umraeðaunclassified

“…11,12 tíðni skurðdauða og alvarlegra fylgikvilla eftir fleyg-og geiraskurði er lág og ekki reyndist marktaekur munur á þessum þáttum borið saman við fyrrgreindu rannsóknirnar á blaðnámi. 11,12 Skurðdauði var enginn í báðum rannsóknum, sem verður að teljast góður árangur. Þegar tíðni fylgikvilla eftir fleyg-og geiraskurði er borin saman við lungnabrottnámsaðgerðir á Íslandi 1988-2007 13 er munurinn meiri og er það í samraemi við erlendar rannsóknir.…”

Section: Umraeðaunclassified

“…17,19 Þannig reyndist tíðni alvarlegra fylgikvilla eftir lungnabrottnám 15,6% og skurðdauði 3,9%, enda flestir þessara sjúklinga með miðlaeg og stór aexli og aðeins 15,8% sjúklinga á stigi i. 13 Fleiri sjúklingar greindust með sjúkdóm á stigi i eftir fleygeða geiraskurð en eftir blaðnám 11,12 (p<0,02) sem gaeti átt þátt í góðum árangri hvað lífshorfur snertir. Eitlasýni voru ekki tekin í 87,2% fleyg-og geiraskurðaðgerða hér á landi og aðeins ein miðmaetisspeglun var framkvaemd fyrir aðgerð.…”

Section: Umraeðaunclassified

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Árangur fleyg- og geiraskurða við lungnakrabbameini á Íslandi

Alexandersson¹,

Jónsson²,

Ísaksson³

et al. 2011

LBL

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A sublobar resection is performed on patients with non-small cell lung cancer (NSCLC) who are not candidates for a lobectomy due to reduced pulmonary function or comorbid disease. The aim of this study was to investigate the outcomes of these operations in Iceland. Material and methods: A retrospective study of all patients with NSCLC who underwent wedge resection or segmentectomy with curative intent during 1994-2008. Data on indication, pathological TNM-stage, complications and overall survival was analyzed. All histological samples were re-evaluated. results: Forty four patients underwent 42 wedge and 5 segmental resections (age 69.1 yrs, 55.3% female), with 38.3% of cases detected incidentally. The majority of patients (55.3%) had a history of coronary artery disease and 40.4% had chronic obstructive pulmonary disease. Mean operative time was 83 minutes (range 30-131), mean intraoperative bleeding was 260 ml (range 100-650) and median hospital stay was 9 days (range 4-24). Pneumonia (14.9%) and prolonged air leakage (12.8%) were the most common complications. Two patients had major complications and 36.2% stayed in the intensive care unit overnight. No deaths occurred within 30 days of surgery. Adenocarcinoma was the most common histological type (66.7%). Most cases were stage IA/IB (78.7%), 17.0% were stage IIA/IIB and 4.3% were stage IIIA. One and 5 year survival was 85.1% and 40.9% respectively. Conclusion: In Iceland, both survival and complication rate after sublobar resection for NSCLC are comparable to results published for lobectomies, even though a higher percentage of patients have underlying cardiopulmonary disease.

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Section: Inngangurunclassified

Section: Niðurstöðurunclassified

Section: Umraeðaunclassified

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Árangur fleyg- og geiraskurða við lungnakrabbameini á Íslandi

Alexandersson¹,

Jónsson²,

Ísaksson³

et al. 2011

LBL

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Middle Lobe Syndrome: A Review of Clinicopathological Features, Diagnosis and Treatment

Guðbjartsson¹,

Guðmundsson

2012

Respiration

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Middle lobe syndrome (MLS) is a rare but important clinical entity that has been poorly defined in the literature. It is characterized by recurrent or chronic collapse of the middle lobe of the right lung but can also involve the lingula of the left lung. Pathophysiologically, there are two forms of MLS, namely obstructive and nonobstructive. Obstructive MLS is usually caused by endobronchial lesions or extrinsic compression of the middle lobe bronchus such as from hilar lymphadenopathy or tumors of neoplastic origin, resulting in postobstructive atelectasis and pneumonitis. In the nonobstructive type, no obstruction of the middle lobe bronchus is evident during bronchoscopy or with computerized tomography of the chest. The etiology of the nonobstructive form is not completely understood. Inefficient collateral ventilation, infection and inflammation in the middle lobe or lingula are thought to play a role, and bronchiectasis is the most common histological finding. Patients with proven endobronchial lesions or malignancy are usually offered surgical resection directly. This contrasts with nonobstructive MLS, where most patients respond to medical treatment consisting of bronchodilators, mucolytics and broad-spectrum antibiotics. However, some patients do not respond to conservative treatment and may suffer irreversible damage of the middle lobe or lingula, in addition to having recurrent symptoms of infection or inflammation. These selected patients can be offered surgical resection of the middle lobe or lingula, which is associated with a low mortality rate and favorable outcome.

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