Influence of caliber mismatch on patients' clinical course after sleeve lobectomy
Autor: | Takuma Tsukioka, Nobuhiro Izumi, Hidetoshi Inoue, Hiroaki Komatsu, Ryuichi Ito, T. Kimura, Noritoshi Nishiyama, Hikaru Miyamoto |
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Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms Primary lung cancer Pleural effusion Respiratory complication Bronchopleural fistula Bronchi 030204 cardiovascular system & hematology Anastomosis 03 medical and health sciences 0302 clinical medicine Main Bronchus Carcinoma Non-Small-Cell Lung Medicine Bronchoplasty Humans 気管支形成術 Pneumonectomy Bronchus business.industry Anastomosis Surgical Sleeve Lobectomy General Medicine medicine.disease Surgery Cardiac surgery Caliber mismatch medicine.anatomical_structure Cardiothoracic surgery 030220 oncology & carcinogenesis Cardiology and Cardiovascular Medicine business |
Zdroj: | General thoracic and cardiovascular surgery. 69(7) |
ISSN: | 1863-6713 |
Popis: | Respiratory complications are critical events after sleeve lobectomy. A caliber mismatch is an important factor in wound healing at the anastomotic site. This study aimed to determine the influence of caliber mismatches on patients’ clinical courses after sleeve lobectomy. We investigated the clinical courses of 56 patients with primary lung cancer who underwent pulmonary resection with end-to-end bronchoplasty. Anastomoses between the main bronchus and the segmental, right upper or middle bronchus, and between the trunks intermedius and the segmental or middle bronchus are categorized as an “anastomosis with caliber mismatch”. Among the 56 patients, 22 underwent bronchoplasty with caliber mismatch. There were no in-hospital deaths, and the mortality rates at the 30- and 90-day evaluations were zero. Respiratory complications (n = 10, 52%, p = 0.005), such as pneumonia (n = 7, 32%, p = 0.029), retention of pleural effusion (n = 6, 27%, p = 0.026) and bronchopleural fistula (n = 3, 14%, p = 0.027), were significantly increased after bronchoplasty with caliber mismatch. Lower body mass index (BMI) is a significant risk factor for respiratory complications after sleeve lobectomy with caliber mismatch (median value; 23.2 vs 21.2, p = 0.036). Significant respiratory complications are apparent after bronchoplasty with caliber mismatch, especially patients with low BMI have a high risk of respiratory complications. Appropriate patient selection and cautious perioperative management are mandatory for this type of lung-preserving surgery. |
Databáze: | OpenAIRE |
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