Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 8/2016

01-08-2016 | Original Article

Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection

Authors: Satoru Kobayashi, Yoko Karube, Morimichi Nishihira, Takashi Inoue, Osamu Araki, Sumiko Maeda, Tetsu Sado, Yuji Matsumura, Masayuki Chida

Published in: General Thoracic and Cardiovascular Surgery | Issue 8/2016

Login to get access

Abstract

Objective

Acute exacerbation (AE) of idiopathic interstitial pneumonia (IP) is a potentially fatal postoperative complication following lung cancer resection. Postoperative pyothorax (PP) following development of a bronchopleural fistula (BPF) after lung surgery induces continuous inflammation and may affect the occurrence of AE. We investigated the relationship between AE and PP in patients who underwent pulmonary resection for lung cancer.

Methods

A total of 941 patients who underwent lung resection due to primary lung cancer from 2006 to 2015 at our hospital were investigated.

Results

Of the 941 enrolled patients, 137 (14.6 %) had idiopathic IP and were predominantly male (p < 0.01). Pathological stage Ia and adenocarcinoma were observed at significantly high rates in the non-IP group (p < 0.01). Patients with IP showed a tendency for a higher percentage of PP (p = 0.054). Of the 137 patients with IP, 17 (12.4 %) showed postoperative AE. Furthermore, PP was observed in three cases in the AE(+) group and two in the AE(−) group. PP had a correlation with a significantly higher incidence of AE (p = 0.007).

Conclusion

PP was found to be a significant risk factor for postoperative AE in lung cancer patients undergoing a pulmonary resection. Since IP itself is likely a risk factor for PP, prevention of BPF is important for patients with IP, as it can lead to PP.
Literature
1.
Kumar P, Goldstraw P, Yamada K, Nicholson AG, Wells AU, Hansell DM, Dubois RM, Ladas G. Pulmonary fibrosis and lung cancer: risk and benefit analysis of pulmonary resection. J Thorac Cardiovasc Surg. 2003;125:1321–7.CrossRefPubMed
2.
Tanita T, Chida M, Hoshikawa Y, Handa M, Sato M, Sagawa M, et al. Experience with fatal interstitial pneumonia after operation for lung cancer. J Cardiovasc Surg. 2001;42:125–9.
3.
Chida M, Ono S, Hoshikawa Y, Kondo T. Subclinical idiopathic pulmonary fibrosis is also a risk factor of post-operative acute respiratory distress syndrome following thoracic surgery. Eur J Cardiothorac Surg. 2008;34:877–80.CrossRef
4.
Sato T, Teramukai S, Kondo H, Watanabe A, Ebina M, Kishi K, et al. Impact and predictors of acute exacerbation of interstitial lung diseases after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg. 2014;147:1604–11.CrossRefPubMed
5.
Chida M, Kobayashi S, Karube K, Hayama M, Tamura M, Ishihama H, Oyaizu T. Incidence of acute exacerbation of interstitial pneumonia in operated lung cancer: institutional report and review. Ann Thorac Cardiovasc Surg. 2012;18:314–7.CrossRefPubMed
6.
Collard HR, Moore BB, Flaherty KR, Brown KK, Kaner RJ, King TE, et al. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Resp Crit Care Med. 2007;176:636–43.CrossRefPubMedPubMedCentral
7.
Masuda M, Kuwano H, Okumura M, Arai H, Endo S, Doki Y, et al. Thoracic and cardiovascular surgery in Japan during 2013: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2013;. doi:10.​1007/​s11748-015-0590-3.
8.
The Japanese Respiratory Society. Concept, diagnosis and treatment of IIPs. In: Sugiyama Y, Honma S, editors. Idiopathic interstitial pneumonias: diagnosis and treatment. 2nd ed. Tokyo: Nankodo; 2011. p. 51–101.
9.
Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guideline for diagnosis and management. Am J Respi Crit Care Med. 2011;183:788–824.CrossRef
10.
11.
Strieter RM, Belperio JA, Keane MP. CXC chemokines in vascular remodeling related to pulmonary fibrosis. Am J Respir Cell Mol Biol. 2003;29:S67–9.PubMed
12.
Richards TJ, Kaminski N, Baribaud F, Flavin S, Brodmerkel C, Horowitz D, et al. Peripheral blood proteins predict mortality in idiopathic pulmonary fibrosis. Am J Crit Respir Med. 2012;185:67–76.CrossRef
13.
Sato T, Kondo H, Watanabe A, Nakajima J, Niwa H, Horio H, et al. A simple risk score system for predicting acute exacerbation of interstitial pneumonia after pulmonary resection in lung cancer patients. Gen Thorac Cardiovasc Surg. 2015;63:164–72.CrossRefPubMed
14.
Sato T, Watanabe A, Kondo H, Kanzaki M, Okubo K, Yokoi K, et al. Long-term results and predictors of survival after surgical resection of patients with lung cancer and interstitial lung diseases. J Thorac Cardiovasc Surg. 2015;149:64–9.CrossRefPubMed
Metadata
Title
Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection
Authors
Satoru Kobayashi
Yoko Karube
Morimichi Nishihira
Takashi Inoue
Osamu Araki
Sumiko Maeda
Tetsu Sado
Yuji Matsumura
Masayuki Chida
Publication date
01-08-2016
Publisher
Springer Japan
Published in
General Thoracic and Cardiovascular Surgery / Issue 8/2016
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-016-0665-9

Other articles of this Issue 8/2016

General Thoracic and Cardiovascular Surgery 8/2016 Go to the issue

Current Topics Review Article

Aortic valve replacement and prosthesis-patient mismatch in the era of trans-catheter aortic valve implantation

Erratum

Erratum to: Thoracic and cardiovascular surgery in Japan during 2013

Case Report

Coronary artery bypass grafting in a patient with hemophilia B: continuous recombinant factor IX infusion as per the Japanese guidelines for replacement therapy

Case Report

Multidisciplinary approach to treatment of radiation-induced chest wall sarcoma

Case Report

Successful resection of recurrent mediastinal liposarcoma using preoperative evaluation of organ invasion by four-dimensional computed tomography

Original Article

Efficacy of vacuum-assisted closure therapy on rehabilitation during the treatment for surgical site infection after cardiovascular surgery