Skip to main content
Erschienen in: General Thoracic and Cardiovascular Surgery 8/2016

08.06.2016 | Original Article

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

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

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Harari S, Caminati A. IPF: new insight on pathogenesis and treatment. Allergy. 2010;65:537–53.CrossRefPubMed Harari S, Caminati A. IPF: new insight on pathogenesis and treatment. Allergy. 2010;65:537–53.CrossRefPubMed
11.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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
Metadaten
Titel
Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection
verfasst von
Satoru Kobayashi
Yoko Karube
Morimichi Nishihira
Takashi Inoue
Osamu Araki
Sumiko Maeda
Tetsu Sado
Yuji Matsumura
Masayuki Chida
Publikationsdatum
08.06.2016
Verlag
Springer Japan
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 8/2016
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-016-0665-9

Weitere Artikel der Ausgabe 8/2016

General Thoracic and Cardiovascular Surgery 8/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.