Background: Patients after lung lobectomy for a malignant disease have 2% chance per year of developing a metachronous second lung cancer. The aim of our study was to evaluate factors influencing the postoperative outcome in patients who underwent iterative pulmonary surgery after contra lateral lobectomy. Materials and Methods: Between October 2004 and February 2007 48 patients underwent contralateral lung resection after a prior lobectomy for cancer. Patients were divided into two groups according to the second operation: anatomical resections (group A) and non- anatomical resections (group B). All pre-operative (clinical data) and intra-operative data [anaesthesiological management, time of one- lung ventilation (OLV), and overall time of operation (OT)] were evaluated in order to compare overall mortality and postoperative complications between the 2 groups. Results: There were 26 lobectomies and 22 atypical resections. No post-operative deaths occurred. Overall postoperative morbidity was 35% (9/26) and 23% (5/22) respectively in groups A and B. Respiratory morbidity in group A and B was 30% (8/26) and 4,3% (1/22) (p= 0.037), respectively. In multivariate analysis, factors influencing complications were: time of OLV (p=0,038); OT (p=0,018), intraoperative saturation below 90% (p=0,002) and Diffusing Lung Carbon Monoxide DLCO (p=0,001). Conclusions: Contra-lateral pulmonary resection after lobectomy for malignant disease is a feasible procedure with low mortality and acceptable morbidity. An accurate patients selection and a careful intra-operative surgical and anaestesiological management could decrease post-operative complications.

Iterative lung resection: Risk factors influencing the post-operative outcome / R. Gasparri, J. Guarize, P. Maisonneuve, A. Tosoni, D. Galetta, F. Petrella, A. Borri, L. Spaggiari. ((Intervento presentato al convegno Annual Meeting of the Pennsylvania Association for Thoracic Surgery/Eastern Cardiothoracic tenutosi a Pennsylvania nel 2010.

Iterative lung resection: Risk factors influencing the post-operative outcome

D. Galetta;F. Petrella;L. Spaggiari
2010

Abstract

Background: Patients after lung lobectomy for a malignant disease have 2% chance per year of developing a metachronous second lung cancer. The aim of our study was to evaluate factors influencing the postoperative outcome in patients who underwent iterative pulmonary surgery after contra lateral lobectomy. Materials and Methods: Between October 2004 and February 2007 48 patients underwent contralateral lung resection after a prior lobectomy for cancer. Patients were divided into two groups according to the second operation: anatomical resections (group A) and non- anatomical resections (group B). All pre-operative (clinical data) and intra-operative data [anaesthesiological management, time of one- lung ventilation (OLV), and overall time of operation (OT)] were evaluated in order to compare overall mortality and postoperative complications between the 2 groups. Results: There were 26 lobectomies and 22 atypical resections. No post-operative deaths occurred. Overall postoperative morbidity was 35% (9/26) and 23% (5/22) respectively in groups A and B. Respiratory morbidity in group A and B was 30% (8/26) and 4,3% (1/22) (p= 0.037), respectively. In multivariate analysis, factors influencing complications were: time of OLV (p=0,038); OT (p=0,018), intraoperative saturation below 90% (p=0,002) and Diffusing Lung Carbon Monoxide DLCO (p=0,001). Conclusions: Contra-lateral pulmonary resection after lobectomy for malignant disease is a feasible procedure with low mortality and acceptable morbidity. An accurate patients selection and a careful intra-operative surgical and anaestesiological management could decrease post-operative complications.
Settore MED/21 - Chirurgia Toracica
Iterative lung resection: Risk factors influencing the post-operative outcome / R. Gasparri, J. Guarize, P. Maisonneuve, A. Tosoni, D. Galetta, F. Petrella, A. Borri, L. Spaggiari. ((Intervento presentato al convegno Annual Meeting of the Pennsylvania Association for Thoracic Surgery/Eastern Cardiothoracic tenutosi a Pennsylvania nel 2010.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/200318
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