Left Upper Lobectomy for Lung Cancer as a Risk Factor for Cerebral Infarction: A Systematic Review and Meta-Analysis

Wankhede, Durgesh; Grover, Sandeep; Awendila, Lindila

doi:10.1007/s00408-021-00480-4

Cited by 10 publications

(4 citation statements)

References 49 publications

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“…In previous publications, the incidence of postoperative CI was 0.6-1.6% and LUL was a significant risk factor for postoperative CI [1-5, 12, 17], which was almost consistent with our results. Other risk factors, such as older age, male sex, and DM have also been reported [17,18]. Lower values of FEV 1 /FVC could have been related to chronic obstructive pulmonary disease (COPD).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative cerebral infarction in Lung Cancer patients: a retrospective study

Maru

Hino

Utsumi

et al. 2023

J Cardiothorac Surg

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Background Postoperative cerebral infarction is a rare but serious complication after lung cancer surgery. We aimed to investigate the risk factors and evaluate the efficiency of our devised surgical procedure to prevent cerebral infarction. Methods We retrospectively examined 1,189 patients who underwent a single lobectomy for lung cancer at our institution. We identified the risk factors for cerebral infarction and investigated the preventive effects of performing resection of the pulmonary vein as the last step of the surgical procedure during left upper lobectomy. Results Among the 1,189 patients, we identified 5 male patients (0.4%) with postoperative cerebral infarction. All five underwent left-sided lobectomy including three upper and two lower lobectomies. Left-sided lobectomy, a lower forced expiratory volume in 1 s, and lower body mass index were associated with postoperative cerebral infarction (Ps < 0.05). The 274 patients who underwent left upper lobectomy were stratified by two procedures: lobectomy with resection of the pulmonary vein as the last step of the surgical procedure (n = 120) and the standard procedure (n = 154). The former procedure significantly shortened the length of the pulmonary vein stump when compared with the standard procedure (mean stump length: 15.1 vs. 18.6 mm, P < 0.01), and the shorter pulmonary vein might possibly prevent postoperative cerebral infarction (frequency: 0.8% vs. 1.3%, Odds ratio: 0.19, P = 0.31). Conclusions Resecting the pulmonary vein as the last step during the left upper lobectomy enabled the length of the pulmonary stump to be significantly shorter, which may contribute to preventing cerebral infarction.

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Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative cerebral infarction in Lung Cancer patients: a retrospective study

Maru

Hino

Utsumi

et al. 2023

J Cardiothorac Surg

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“…Lung lobectomy can lead to cerebral infarction due to thrombus formation in the pulmonary vein (PV) stump ( 1 , 2 ). However, in contrast to the details of the acute phase, those of the long-term postoperative phase of lung lobectomy have not been reported in the relevant literature.…”

Section: Introductionmentioning

confidence: 99%

Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction, Even in the Long-term Postoperative Phase

et al. 2023

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The vein stump created after lung lobectomy has been reported to cause thrombus and subsequently cerebral infarction. However, its assessment after a long-term postoperative course remains unreported. The pulmonary vein stump is a structure near the left atrial appendage; therefore, such patients may be at a constant risk of thrombus formation. We herein report two cases of cerebral infarction associated with lung lobectomy. Transesophageal echocardiography revealed mobile thrombi in the pulmonary vein stump. Both patients had cancer recurrence, and hypercoagulability may have contributed to thrombus formation. This vein stump should be investigated as an embolic source, even after a long postoperative duration.

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“…Thrombotic cerebral infarction is the most frequent cause. Known risk factors for post-lung-resection cerebral infarction include ageing, male sex, the presence of comorbidities, anticoagulant therapy and left upper lobectomy [ 2 ]. Here, we report an unusual case of postoperative cerebral infarction caused by a structural abnormality of the middle cerebral artery.…”

Section: Introductionmentioning

confidence: 99%

A case of cerebral infarction due to aplastic or twig-like middle cerebral artery after lung cancer surgery

Hato

Yamaguchi

Sugiyama

et al. 2022

Journal of Surgical Case Reports

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Aplastic/twig-like middle cerebral artery is a rare vascular abnormality. We report a case of postoperative cerebral infarction caused by this disease. The patient is a male in his 40s. A 9-cm tumour was revealed to have invaded the superior vena cava from his right lung. He underwent right upper and middle bilobectomy. Due to the vascular invasion, the intraoperative bleeding exceeded 2 litres. Mechanical ventilation was required for postoperative pneumonia. After extubation, he was unable to write and was found to have cerebral infiltration in the left middle cerebral artery region. The cause of the cerebral infarction was investigated, but no thrombus in the left atrium or arteriosclerosis was found. No atrial fibrillation was observed during or after the surgery. Magnetic resonance angiography of the brain revealed an aplastic/twig-like middle cerebral artery.

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Left Upper Lobectomy for Lung Cancer as a Risk Factor for Cerebral Infarction: A Systematic Review and Meta-Analysis

Cited by 10 publications

References 49 publications

Risk factors for postoperative cerebral infarction in Lung Cancer patients: a retrospective study

Risk factors for postoperative cerebral infarction in Lung Cancer patients: a retrospective study

Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction, Even in the Long-term Postoperative Phase

A case of cerebral infarction due to aplastic or twig-like middle cerebral artery after lung cancer surgery

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