演題

IS-9-7

Risk factor of respiratory failure following contralateral lung surgery for secondary lung cancer

[演者] 柴野 智毅:1
[著者] 峯岸 健太郎:1, 真木 充:2, 光田 清佳:1, 中野 智之:1, 遠藤 哲哉:2, 山本 真一:1, 手塚 憲志:1, 長谷川 剛:1, 遠藤 俊輔:1
1:自治医科大学呼吸器外科, 2:自治医科大学さいたま医療センター呼吸器外科

Background: The number of patients who outbreak a solitary lung cancer after the initial surgery has increased. Surgery may provide a better prognosis than chemotherapy for these patients, whereas operation risk of the second surgery is controversial. Methods: We retrospective investigated patients who received contralateral lung surgery for metachronous or recurrent lung cancer between April 2007 and April 2014 in our institution. Only patients who received anatomical resection (segmentectomy, lobectomy, or pneumonectomy) were included. The risk factor for PORF was analyzed using univariative analyses. Survival rates were reported by Kaplan-Meier method. Results: 33 patients received contralateral second surgery for metachronous or recurrent lung cancer. 25 were male, and 8 were female. PORF requiring mechanical ventilation occurred in three patients (9%), which was the majority of all perioperative complications. Age over 80 (p<0.01), smoking history of brikmann index over 1000 (p=0.04), preoperative vital capacity (p=0.04), surgical time (p<0.01), blood loss during surgery (p<0.01), and right lower lobectomy (p=0.04) was the risk factor for PORF. Median follow up was 39 months. One year and three year overall survival were 86.4% and 67.2%.Conclusion: For surgery can provide a good long-term outcome, it must be consider as a primary treatment for secondary lung cancer. Avoiding these factors might decrease the risk for secondary surgery.
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