Virtual Library
Start Your Search
K. Takegahara
Author of
-
+
P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
-
+
P1.08-013 - Preoperative Managements for Pulmonary Complications Using Inhalations in Lung Cancer Patients with Chronic Obstructive Pulmonary Disease (ID 5566)
14:30 - 14:30 | Author(s): K. Takegahara
- Abstract
Background:
Chronic obstructive pulmonary disease (COPD) is related to the prognosis of patients with lung cancer, and one of risk factors of respiratory complications after surgical resections. This study aimed to investigate whether perioperative inhalations of long-acting beta-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs) would decrease the postoperative complications in lung cancer patients with COPD.
Methods:
We retrospectively analyzed 108 patients with COPD who underwent pulmonary resections for primary lung cancer at our hospital between January 2013 and January 2016, in order to determine the association between the incidence of postoperative complications (e.g., prolonged air leakage and pneumonia) and the use of LABAs or LAMAs.
Results:
Among 108 patients with COPD patients, there were 86 men and 22 women, with a mean age of 69.3 years (range, 46–84). The mean Brinkman index was 1172.1(range, 50-3480). The mean FEV1.0/FVC was 61.4%(range, 26.8%-69.9%). The surgical procedures were partial resection in 11 patients, pulmonary segmentectomy in 3 patients, lobectomy in 92 patients, and pneumonectomy in 2 patients. The histological types showed adenocarcinoma in 53 patients, squamous cell carcinoma in 38 patients, adenosquamous carcinoma in 5 patients, large cell neuroendocrine carcinoma in 3 patients, large cell carcinoma in 4 patients, small cell carcinoma in one patient, and pleomorphic carcinoma in 4 patients. There were 29 postoperative complications in COPD (26.9%), prolonged air leak (more than 7 days) 14 cases, pneumonia 9 cases, arrhythmia 2 cases, chylothorax 2 cases, wound infection 2 cases. The frequency of postoperative pulmonary complications such as prolonged air leakage and pneumonia, was significant higher in COPD (23 cases, 21.3%) than in non COPD (15 cases,6.7%). Inhaled bronchodilators such as LAMA or LABA were prescribed to 34 cases in COPD, not to 74 cases. The pulmonary complications were significant lower in LAMA or LABA users (3 cases, 8.8%) than in no users (20 cases, 27.0%).
Conclusion:
For lung cancer patients with COPD, preoperative management using the inhalants with LABA or LAMA, and smoking cessation can reduce the frequency of the postoperative pulmonary complications after surgical lung resection. The inhalants with LAMA or LABA may be adapted for the management of not only perioperative care but also long-term survival of COPD patients after surgery.
