Gönül SAĞIROĞLU, Yener YÖRÜK, Y Altemur KARAMUSTAFAOĞLU, Elif ÇOPUROĞLU, Burhan MEYDAN, Erdal TAŞÇI, Ayşe BAYSAL

Risk factors for early mortality and morbidity after pneumonectomy

Amaç: Bu çalışmada küçük hücreli dışı akciğer kanseri (KHDAK) nedeni ile pnömonektomi yapılan hastalarda mortalite ve morbiditeyi etkileyen muhtemel risk faktörleri araştırıldı.Çalışmaplanı:Nisan 2008 - Ekim 2009 tarihleri arasında kliniğimizde pnömonektomi yapılan 100 hastanın (96 erkek, 4 kadın; ort. yaş: 58.4±8.9 yıl; dağılım 38-82 yıl) demografik, klinik ve patolojik özellikleri retrospektif olarak incelendi.Bul gu lar: Morbidite ve mortalite oranı sırasıyla %56 ve %14 olarak bulundu. Komplikasyonlar hastaların %46'sında kardiyopulmoner, %7'sinde kanama ve %3'ünde yara yeri enfeksiyonu idi. Yaş, cinsiyet, sigara kullanımı, diyabet, hipertansiyon ve koroner arter hastalığının 30 günlük morbidite ve mortalite üzerine anlamlı etkisi saptanmadı. Neoadjuvan tedavi (p=0.049), sağ pnömonektomi (p=0.01) ve ameliyat sırası kan transfüzyonunun (p=0.049) anlamlı düzeyde artmış morbidite ile ilişkilendirildi. Solunum yetmezliği ve bronkoplevral fistülü olan hastalarda yoğun bakım ve hastanede kalış süresi anlamlı düzeyde daha uzundu.So nuç: Neoadjuvan terapi, sağ pnömonektomi ve ameliyat sırası kan replasmanı olan hastalarda pnömonektomi yüksek riskli bir işlem idi. Ancak, dikkatli ameliyat öncesi değerlendirme, titiz anestezik inceleme ve cerrahi girişimler ile risk faktörlerinin azaltılabileceği kanaatindeyiz.

Pnömonektomi sonrasında erken morbidite ve mortalitenin risk faktörleri

Background: This study aims to investigate possible risk factors which affect the mortality and morbidity of pneumonectomy patients due to the non-small cell lung cancer (NSCLC). Methods: Demographic, clinical and pathological features of 100 patients (96 males, 4 females; mean age 58.4±8.9 years; range 38 to 82 years) who underwent pneumonectomy between April 2008 and October 2009 were retrospectively analyzed. Results: The morbidity and mortality rates were found to be 56% and 14%, respectively. The complications included cardiopulmonary in 46%, bleeding in 7%, and wound infection in 3% patients. There was no significant effect of age, sex, smoking habit, diabetes, hypertension, and coronary artery disease on 30-day morbidity and mortality. Neoadjuvant therapy (p=0.049), right pneumonectomy (p=0.01), and intraoperative blood transfusion (p=0.049) were associated with significantly increased morbidity. The duration of intensive care unit and hospital stays was significantly longer in patients with respiratory failure and bronchopleural fistula. Conclusion: Pneumonectomy is a high-risk procedure in patients with neoadjuvant therapy, right pneumonectomy, and intraoperative blood transfusion. However, we believe that it is possible to reduce the risk factors with careful preoperative evaluation, rigorous anesthetic assessment and surgical interventions.

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