Author of

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10654

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    P1.07-011 - Examination of the relevance of prolonged pulmonary fistula after pulmonary resection for lung cancer and factors about delayed wound healing (ID 1205)

    09:30 - 09:30  |  Author(s): K. Inoue
    • Abstract

    Background
    Prolonged pulmonary fistula is a common complication in pulmonary resection, which happens in 8% to 26% in patients undergoing routine pulmonary resection. And its management is difficult in many cases. Air leakages are associated with prolonged hospital stays, infectious, cardiopulmonary complications, and reoperation occasionally despite of the progress of the recent conservative cure. Blood coagulation factor XIII (BCF XIII) is known to play a role in wound healing. However little is known about the role of BCF XIII in the field of thoracic surgery. BCF XIII is known to fasciculate closure of fistula in gastro-intestine surgery. This time, we examine the relationship for prolonged air leakage and BCF XIII diabetes, chronic obstructive pulmonary disease (COPD), and total protein amount of postoperative.

    Methods
    In 32 patients who underwent pulmonary resection for lung cancer at Bell-land general hospital or Osaka city university hospital and experienced air leakage for at least 2 days after operation. Pre-operative HbA1c and BCF XIII and pulmonary function measured within 2 weeks pre-operatively .Post-operative total protein (TP) and BCF XIII measured at 5 days post-operatively. We evaluated the relationship between BCF XIII or HbA1c or TP or COPD and duration of chest drain placement respectively.For statistical analysis, t-test was used

    Results
    Six patients experienced a decrease in factor XIII to 70% or under normal range that was indication for administration of BCF XIII. The mean duration of chest drain placement was 5.2± 2.8 days in patients with post-operative BCF XIII level of ≥71% compared to 8.3 ± 2.8 days in those with post-operative BCF XIII level of ≤70%. Patients with post-operative BCF XIII level of ≤70% required drain placement for a significantly longer period (p<0.05). In this analysis, we did not recognize significant difference in other factors (HbA1c≦6.5% group and HbA1c≧6.6% group, Post operative TP ≧6.6 g/dl group and TP ≦6.5 g/dl , forced expiratory volume 1.0%(FEV1.0%)≧70% group and FEV1.0%＜70% group).

    Conclusion
    Factor XIII promotes crosslink of fibrin in the early stages of wound healing. Thus, factor XIII is considered to be consumed for lesion repair. In this study, we were considered the possibility BCF XIII is related to lung healing fistula. In diabetic patients, the occurrence of delayed wound healing has been reported frequently. No significant difference was noted between diabetic and non-diabetic patients in this study. We continue to increase the study case in the future, we want to evaluate the relationship between BCF XIII, diabetes or nutrition and the drainage period.