Operative Mortality and Respiratory Complications After Lung Resection for Cancer: Impact of Chronic Obstructive Pulmonary Disease and Time Trends

Licker, Marc; Widikker, Igor; Robert, John; Frey, Jean-George; Spiliopoulos, Anastase; Ellenberger, Christoph; Schweizer, Alexandre; Tschopp, Jean‐Marie

doi:10.1016/j.athoracsur.2005.11.048

Cited by 341 publications

(236 citation statements)

References 35 publications

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“…The primary composite morbidity rate included operative mortality (death within 30 days of surgery or later if the patient was still hospitalised), as well as cardiovascular complications (myocardial infarction, arrhythmias, congestive heart failure, stroke, thromboembolism or renal dysfunction) and pulmonary complications (atelectasis, pneumonia or acute lung injury (ALI)) as detailed in the appendix and consistent with previous studies [2,13].…”

Section: Data Collectionmentioning

confidence: 87%

“…Interestingly, this algorithm dates back to the mid-1990s, being tested and subsequently validated in two cohorts of 80 and 135 patients [18,19]. Since this pioneering work, advances in surgical techniques and anaesthetic management have led to improved perioperative outcomes, despite increasing proportions of elderly and higher-risk patients [2,20,21].…”

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confidence: 99%

“…Overall, perioperative mortality rates range between 2% and 5% and the incidence of postoperative cardiopulmonary complications varies between 20% and 40%, resulting in prolonged hospital stay and increased healthcare costs [1][2][3]. Although up to 25% of patients may benefit from surgical resection, in the remaining patients, either the cancer stage is considered too advanced or comorbidities are judged too severe, precluding any benefit in terms of post-operative survival and quality of life [4].…”

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confidence: 99%

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Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery

Licker¹,

Schnyder²,

Frey³

et al. 2010

Eur Respir J

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Over the past decades, major progress in patient selection, surgical techniques and anaesthetic management have largely contributed to improved outcome in lung cancer surgery. The purpose of this study was to identify predictors of post-operative cardiopulmonary morbidity in patients with a forced expiratory volume in 1 s ,80% predicted, who underwent cardiopulmonary exercise testing (CPET).In this observational study, 210 consecutive patients with lung cancer underwent CPET with completed data over a 9-yr period (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009).Cardiopulmonary complications occurred in 46 (22%) patients, including four (1.9%) deaths. On logistic regression analysis, peak oxygen uptake (peak V9O 2 ) and anaesthesia duration were independent risk factors of both cardiovascular and pulmonary complications; age and the extent of lung resection were additional predictors of cardiovascular complications, whereas tidal volume during one-lung ventilation was a predictor of pulmonary complications. Compared with patients with peak V9O 2 .17 mL?kg, those with a peak V9O 2 ,10 mL?kg -1 ?min -1 had a four-fold higher incidence of cardiac and pulmonary morbidity. Our data support the use of pre-operative CPET and the application of an intra-operative protective ventilation strategy. Further studies should evaluate whether pre-operative physical training can improve post-operative outcome.

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Section: Data Collectionmentioning

confidence: 87%

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confidence: 99%

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confidence: 99%

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Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery

Licker¹,

Schnyder²,

Frey³

et al. 2010

Eur Respir J

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“…Послеоперационная легочная дисфункция -од на из основных причин послеоперационной летальнос ти в торакальной хирургии и при вмешательствах на верхнем этаже брюшной полости [10,11]. Затруднение откашливания, вызванное послеоперационной болью, нарушает эвакуацию бронхиального секрета, что спо собствует ателектазированию с по следующим развитием легочной ин фекции.…”

Section: показательunclassified

Comparative Characterization of Various Types of Postoperative Analgesia in Patients with Lung Cancer

Marchenkov¹,

Рябчиков²,

Shulgin³

2011

rmt

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Цель исследования -провести сравнительное исследование эффективности послеоперационного обезболивания у больных с онкологическими легочными заболеваниями с использованием контролируемой пациентом внутривенной анальгезии (КПВА), продленной эпидуральной анальгезии (ЭА) + КПВА и интраплевральной анальгезии (ИПА) + КПВА. Материал и методы. Обследовано 46 пациентов, перенесших торакотомии и резекции легкого. В зависимо сти от варианта обезболивания пациенты были разделены на три группы: группа А (n=16) -КПВА 0,1% морфином с использованием программируемых шприцевых насосов; группа В (n=14) -постоянная эпидуральная инфузия 0,2% раствора ропивакаина + КПВА морфином; группа С (n=16) -интраплевральное болюсное введение 0,5% ропивакаи на + КПВА. Оценивали степень седации, частоту возникновения и выраженность побочных паранаркотических эф фектов. Результаты исследования. Применение моно КПВА у пациентов, перенесших операции высокой травма тичности, характеризуется низкой эффективностью и высокой частотой побочных эффектов по сравнению с другими методами. Так, в группе А избыточная седация регистрировалась в 12,5%, кожный зуд -18,7%, задержка мочи -6,3%, тошнота/рвота -18,8%. В группах В и С выявлено всего по 1 случаю рвоты и кожного зуда. Это обусловлено достоверно низким количеством использованного морфина при продленной ЭА и ИПА. В группе А суточное количе ство морфина составило в среднем 0,63 мг/кг/сут, в группе В -0,19 мг/кг/сут, в группе С -0,2 мг/кг/сут (р<0,01). Заключение. Использование продленной ЭА и ИПА в послеоперационном периоде повышало мобильность пациен тов, улучшало показатели функций внешнего дыхания и кардиогемодинамики, что способствовало снижению количе ства гнойно септических осложнений и времени реконвалесценции. ИПА у больных, перенесших резекцию легких, полностью обеспечивает потребности больного в купировании боли и может быть рекомендована для проведения по слеоперационной анальгезии наряду с ЭА. Ключевые слова: торакотомия, контролируемая пациентом внутривенная анальгезия, продленная эпидуральная анальгезия, интраплевральная анальгезия.Objective: to comparatively study the efficiency of postoperative analgesia in patients with lung cancers, by using patient controlled intravenous analgesia (PCIA), continuous epidural analgesia (EA) + PCIA, and intrapleural anal gesia (IPA) + PCIA. Subjects and methods. Forty six patients who had undergone thoracotomy and lung resection were examined. According to the mode of analgesia, the patients were divided into 3 groups: A (n=16) PCIA with 0.1% morphine, by applying programmed syringe pumps; B (n=14) continuous epidural infusion of 0.2% ropivacaine solution + PCIA with morphine; C (n=16) intrapleural bolus infusion of 0.5% ropivacaine + PCIA. The degree of sedation and the incidence and degree of side paranarcotic effects were estimated. Results. The use of mono PCIA in patients who have undergone high traumatic surgery is characterized by its low efficiency and a high rate of adverse reactions as compared with the other methods. Group A showed excess sedati...

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“…A retrospective analysis of 1,200 patients demonstrated a reduction of mortality and complications for TEA when pulmonary risk factors were present (i.e., chronic obstructive pulmonary disease) [61]. A prospective, randomized, clinical trial showed a lower rate of postoperative pulmonary complications (6.6 vs. 35 %) in 60 thoracic surgery patients with a 'fast-track' concept (with TEA) compared to conventional management [6].…”

Section: Tea: Clinical Outcome and Side Effectsmentioning

confidence: 99%

Recent Advances in Postoperative Pain Therapy for Thoracic Surgery

Loop

Harris

Grimm

2014

Curr Anesthesiol Rep

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Operative Mortality and Respiratory Complications After Lung Resection for Cancer: Impact of Chronic Obstructive Pulmonary Disease and Time Trends

Cited by 341 publications

References 35 publications

Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery

Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery

Comparative Characterization of Various Types of Postoperative Analgesia in Patients with Lung Cancer

Recent Advances in Postoperative Pain Therapy for Thoracic Surgery

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