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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
Fukushima Journal of Medical Science >
Vol.49 (2003) >
このアイテムの引用には次の識別子を使用してください:
http://ir.fmu.ac.jp/dspace/handle/123456789/143
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| タイトル: | Preoperative pulmonary function as a predictor of respiratory complications and mortality in patients undergoing lung cancer resection |
| その他のタイトル: | Pulmonary functions vs. complications and mortality |
| 著者: | Fujiu, Koichi
Kanno, Ryuzo
Suzuki, Hiroyuki
Shio, Yutaka
Higuchi, Mitsunori
Ohsugi, Jun
Oishi, Akio
Gotoh, Mitsukazu |
| 学内所属: | 外科学第一講座 |
| 誌名/書名: | Fukushima Journal of Medical Science |
| 巻: | 49 |
| 号: | 2 |
| 開始ページ: | 117 |
| 終了ページ: | 127 |
| 発行日: | 2003年12月 |
| 抄録: | OBJECTIVE: We evaluated preoperative pulmonary function as a predictor of respiratory complications and mortality in patients undergoing lung cancer resection to confirm the guideline of the British Thoracic Society: lung cancer surgery in patients with predictive postoperative FEV(1.0) (%FEV(1.0)ppo) > 40% and predictive postoperative diffusion capacity for carbon monoxide (%DL(co)ppo) > 40% can be carried out with average risk. METHODS: We retrospectively studied 356 consecutive patients who underwent pulmonary resection at our Department from January 1992 to December 2001. Preoperative pulmonary function tests included vital capacity (VC), %VC, forced expiratory volume in one second (FEV(1.0)), FEV(1.0)%, diffusion capacity for carbon monoxide (DL(co)), predictive postoperative FEV(1.0) (FEV(1.0)ppo), postoperative respiratory function expressed as a percentage of the predicted normal value (%FEV(1.0) ppo, %DL(co)ppo). Postoperative complications were divided into 2 groups: respiratory complications (pneumonia, atelectasis, etc) and other complications (bronchopleural fistula, prolonged air leak, arrhythmia, etc). RESULTS: Postoperative deaths occurred in 14 (3.9%) patients. Postoperative respiratory complications developed in 27 (7.6%) patients. Pneumonectomy (p < 0.001), preoperative chemotherapy (p < 0.01) and advanced stage (p < 0.05) were identified as risk factors of postoperative deaths. Patients undergoing lobectomy with FEV(1.0) > or = 1,500 ml did not die of respiratory complications. Patients undergoing pneumonectomy with FEV(1.0)ppo > or = 800ml/m2 did not die of respiratory complications. Patients undergoing pneumonectomy with %FEV(1.0)ppo < 40% and %DL(co)ppo < 40% did not survive. Five of the 7 patients who died of respiratory complications were treated with preoperative chemotherapy. The values of their %DL(co)ppo were all less than 40%. By multivariate analysis, %FEV(1.0)ppo was significant independent factor associated postoperative death. CONCLUSIONS: We conclude that the guideline is useful for the selection for surgery of lung cancer patients. If preoperative chemotherapy is performed, the measurement of %DL(co) is recommended before surgery. |
| 出版者: | The Fukushima Society of Medical Science |
| 出版者（異表記）: | 福島医学会 |
| 本文の言語: | eng |
| このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/143 |
| 本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/143/1/FksmJMedSci_49_p117.pdf |
| ISSN: | 0016-2590 |
| DOI: | 10.5387/fms.49.117 |
| PubMed番号: | 15065638 |
| 関連ページ: | https://doi.org/10.5387/fms.49.117 |
| 権利情報: | © 2003 The Fukushima Society of Medical Science |
| 出現コレクション: | Vol.49 (2003)
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