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C. Ji
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P2.16 - Surgery (ID 717)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.16-018 - Phrenic Nerve Injury After Lung Surgery: An Underestimated Problem (ID 9979)
09:30 - 09:30 | Author(s): C. Ji
- Abstract
Background:
Inadvertent phrenic nerve injury (PNI) during lung cancer surgery is not well-studied. It is not always easy to make a clear-cut diagnosis with routine methods. Very few cases have been reported in literature. The aim of our study is to find an easily accessible and precise way to diagnose PNI and then to evaluate the incidence and its impact in early-stage lung cancer patients undergone minimally invasive surgery.
Method:
The first step was to examine the extent of diaphragm elevation in patients with invasive thymomas in whom phrenic nerve was certainly divided. The distance between the diaphragm and the apex of the chest was calculated on chest X-Ray before (DB: Distance before) and after (DA: Distance after) surgery. The following formula was used: [(DB-DA)/DB]x100. The result (mean+SD) was used as criteria for diagnosing PNI. The second step was to study PNI in early-stage lung cancer patients undergone VATS lobectomy using the above criteria.
Result:
Diaphragm elevation was found to be 24.24 +/- 6.2% in 22 invasive thymoma-patients and therefore, 30% was adopted as criteria for the diagnosis of PNI. Among 567 consecutive patients with early-stage lung cancer recruited from January 2014 to December 2016, 43 (7.6%) were diagnosed to have PNI (Table 1). No correlation was detected between PNI and location of the lesion or extent of lymph node dissection. Neither was there any difference in post-operative complications or length of hospital stay. But comparing spirometry data before and 6 months after surgery, reduction in FEV1, FVC, and DLCO was significantly greater in patients with PNI.Figure 1
Conclusion:
We found an easily accessible way to diagnose precisely PNI in lung cancer patients receiving VATS lobectomy. Inadvertent PNI during minimally invasive surgery seems to be underestimated, and it is associated with significant reduction in pulmonary function of the patient.
