Improved results in the management of surgical candidates with lung cancer

Knott‐Craig, Christopher J.; Howell, C. Eric; Parsons, Billy D.; Paulsen, Stephen M.; Brown, Brent; Elkins, Ronald C.

doi:10.1016/s0003-4975(97)00252-x

Cited by 27 publications

(20 citation statements)

References 14 publications

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“…Current mortality rates range from 2 to 12% [1,2,3,4,5,6,7,8,9,10, 14, 15]. The incidence of morbidity is more difficult to assess because of the large variability in definitions employed [1,2,3,4,5,6,7,8,9,10], but there is general agreement that complications occur in a large percentage of patients undergoing lobectomy or pneumonectomy. With respect to postoperative pulmonary morbidity, rates as high as 49% have been reported [16].…”

Section: Discussionmentioning

confidence: 99%

“…Respiratory and cardiocirculatory events account for the great majority of postoperative complications [1,2,3,4,5,6,7,8,9,10], whereas severe bleeding and bronchopleural fistulas are responsible for a minority of adverse events [1, 10]. In the experience of Stephan et al [10], bronchopleural fistulas occurred in 2.1% of patients treated by major lung resection, a value similar to that (2.3%) found by Knott-Craig et al [9]. Hemorrhage was recorded in 0.6% of cases in the series of Licker et al [1] including 634 consecutive patients, but in 4% of cases in the experience of Stephan et al [10].…”

Section: Discussionmentioning

confidence: 99%

“…The need for admission to the ICU after lung resections has not been previously studied; strict comparisons with the literature are thus not possible. On the other hand, the impact on the outcome of several parameters of presurgical work-up has been extensively studied [1,2,3,4,5,6,7,8,9,10], though with discrepancies in results. These differences probably reflect the heterogeneity of the studied populations, pre-, intra-, and postoperative management, as well as definition of complications.…”

Section: Discussionmentioning

confidence: 99%

“…Though operative mortality rates are currently relatively low, morbidity rates remain high [1,2,3,4,5,6,7,8,9,10]. Complications are mainly of cardiac or respiratory type: myocardial infarction, stroke, pulmonary embolism, severe arrhythmias, pneumonias, sepsis, and lung injury represent the most frequent (and serious) complications of lung resections [1,2,3, 7].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of an Appropriate Admission to an ICU after a Major Pulmonary Resection

et al. 2006

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Background: There are no recommendations about admission to an ICU after a major lung resection and there are considerable differences among institutions in this respect. Objectives: To audit the practice of admission to an ICU after a major lung resection and evaluate factors predicting the need for intensive care. Methods: Clinicalrecords of all patients who underwent major pulmonary resections in a 14-month period were reviewed retrospectively. The criteria for postoperative admission to the ICU were: (1) standard pneumonectomy if comorbidity index (CI) >0 and/or ASA score >1, and/or abnormal spirometry or arterial gas analysis; (2) extended pneumonectomy; (3) lobectomy if CI ≧4 and/or ASA ≧3; (4) lobectomy if FEV₁ <60% of predicted; (5) lobectomy if FEV₁ is between 60 and 80% and hypercapnia. Results: Among the 49 patients postoperatively admitted to the surgical ward, only 1 needed late intensive care. Among the 55 patients admitted to the ICU, 25 did not require specific intensive care and were discharged 24 h postoperatively, whereas the remaining 30 patients required specific intensive care. Multivariate analysis identified ASA score, predictive postoperative DL_CO, and predictive postoperative product (PPP) as independent predictors of a need for admission to an ICU. Conclusion: This empirical protocol was useful in identifying patients not likely to need admission to the ICU. ASA score, predictive postoperative DL_CO, and PPP are independent predictors of a need for admission to an ICU.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of an Appropriate Admission to an ICU after a Major Pulmonary Resection

et al. 2006

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“…During treatment by chemotherapy, patients who stopped using tobacco were prepared for thoracic surgery. By analogy, two studies [6,9] demonstrated that preoperative preparation with physiotherapy and medication reduces risks of postoperative complications.…”

Section: Commentmentioning

confidence: 99%

Identification of prognostic factors determining risk groups for lung resection

Bernard¹,

Ferrand²,

Hagry³

et al. 2000

The Annals of Thoracic Surgery

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Background. Pulmonary resection belongs to a group of surgical procedures with significant morbidity and mortality. The aims of this study were to classify postoperative complications and to identify prognostic factors determining risk group.Methods. In a prospective study 500 patients undergoing lung resection (wedge resection, n ‫؍‬ 141; lobectomies, n ‫؍‬ 245; bilobectomies, n ‫؍‬ 12; and pneumonectomies, n ‫؍‬ 102) were included. In 178 patients (36%) pulmonary resections were extended to structures or thoracic organs. Sleeve resection of the bronchus to preserve lung parenchyma was performed in 22 patients.Results. Classification of postoperative complications fell into four categories: patients without postoperative complications; patients with moderate complications (n ‫؍‬ 137); patients with severe complications (n ‫؍‬ 38); and death (n ‫؍‬ 33). Factors adversely affecting postoperative complications by multivariate analysis included pulmonary pathology, bronchoplastic technique, forced expiratory volume in 1 second (FEV 1 ), extended resection, type of lung resection, comorbidity indices, and preoperative chemotherapy. Four risk groups were determined. Risk group I (n ‫؍‬ 60) with the best prognosis included patients with FEV 1 greater than or equal to 80%

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Complications after Pulmonary Resection: Lobectomy and Pneumonectomy

Berry

D’Amico

2009

Complications in Cardiothoracic Surgery

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Improved results in the management of surgical candidates with lung cancer

Cited by 27 publications

References 14 publications

Predictors of an Appropriate Admission to an ICU after a Major Pulmonary Resection

Predictors of an Appropriate Admission to an ICU after a Major Pulmonary Resection

Identification of prognostic factors determining risk groups for lung resection

Complications after Pulmonary Resection: Lobectomy and Pneumonectomy

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