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Is left upper lobectomy for lung cancer a risk factor for cerebral infarction?

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Abstract

Purpose

Cerebral infarction is a rare complication of lung resection that can result in severe sequelae. Our aim was to investigate the characteristics of patients who suffer from cerebral infarction after surgery for lung cancer.

Methods

We retrospectively reviewed all patients who underwent resection of at least a single lobe for lung cancer at our institution between January 2008 and October 2013. We compared the patients who presented with cerebral infarction with those patients who did not within 30 days of surgery.

Results

A total of 562 patients underwent surgery, with five males and one female subsequently experiencing cerebral infarction. Five patients underwent left upper lobectomy and one underwent left lower lobectomy. Patient age, sex, body mass index, smoking index, and operative time were not significantly different between the six patients with postoperative cerebral infarction and the other 556 patients; only the type of operative procedure was significantly different (p < 0.001). Contrast-enhanced computed tomography revealed thrombosis in the stump of the left superior pulmonary vein in patients with postoperative cerebral infarction.

Conclusions

Cerebral infarction occurs at a high frequency in patients who undergo left upper lobectomy for lung cancer. Thrombosis in the left superior pulmonary-vein stump might cause cerebral infarction.

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References

  1. Kam PC, Calcroft RM. Peri-operative stroke in general surgical patients. Anaesthesia. 1997;52:879–83.

    Article  CAS  PubMed  Google Scholar 

  2. Bateman BT, Schumacher HC, Wang S, Shaefi S, Berman MF. Perioperative acute ischemic stroke in noncardiac and nonvascular surgery: incidence, risk factors, and outcomes. Anesthesiology. 2009;110:231–8.

    PubMed  Google Scholar 

  3. Nojiri T, Inoue M, Yamamoto K, Maeda H, Takeuchi Y, Nakagiri T, et al. Inhaled tiotropium to prevent postoperative cardiopulmonary complications in patients with newly diagnosed chronic obstructive pulmonary disease requiring lung cancer surgery. Surg Today. 2014;44:285–90.

    Article  PubMed  Google Scholar 

  4. Nojiri T, Inoue M, Takeuchi Y, Maeda H, Shintani Y, Sawabata N, et al. Impact of cardiopulmonary complications of lung cancer surgery on long-term outcomes. Surg Today. 2015;45:740–5.

    Article  PubMed  Google Scholar 

  5. Ohtaka K, Hida Y, Kaga K, Iimura Y, Shiina N, Muto J, et al. Pulmonary vein thrombosis after video-assisted thoracoscopic left upper lobectomy. J Thorac Cardiovasc Surg. 2012;143:e3–5.

    Article  PubMed  Google Scholar 

  6. Ohtaka K, Hida Y, Kaga K, Kato T, Muto J, Nakada-Kubota R, et al. Thrombosis in the pulmonary vein stump after left upper lobectomy as a possible cause of cerebral infarction. Ann Thorac Surg. 2013;95:1924–8.

    Article  PubMed  Google Scholar 

  7. Xin Y, Hida Y, Kaga K, Iimura Y, Shiina N, Ohtaka K, et al. Left lobectomy might be a risk factor for atrial fibrillation following pulmonary lobectomy. Eur J Cardiothorac Surg. 2014;45:247–50.

    Article  PubMed  Google Scholar 

  8. Ohtaka K, Takahashi Y, Uemura S, Shoji Y, Hayama S, Ichimura T, et al. Blood stasis may cause thrombosis in the left superior pulmonary vein stump after left upper lobectomy. J Cardiothorac Surg. 2014;9:159.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Oura H, Hirose M, Aikawa H, Ishiki M. Abdominal organ infarction encountered immediately after surgery of primary lung cancer. Kyobu Geka. 2005;58:137–42.

    PubMed  Google Scholar 

  10. Tamaki M, Miura K, Norimura S, Kenzaki K, Yosizawa K. Renal infarction and acute arterial obstruction of the lower extremity encountered after surgery for primary lung cancer. Kyobu Geka. 2013;66:138–41.

    PubMed  Google Scholar 

  11. Schwalm S, Ward RP, Spencer KT. Transient ischemic attack in a patient with pulmonary vein thrombosis after left upper lobectomy for squamous cell lung cancer. J Am Soc Echocardiogr. 2004;17:487–8.

    Article  PubMed  Google Scholar 

  12. Ohtaka K, Hida Y, Kaga K, Takahashi Y, Kawase H, Hayama S, et al. Left upper lobectomy can be a risk factor for thrombosis in the pulmonary vein stump. J Cardiothorac Surg. 2014;9:5.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Barbetakis N, Asteriou C, Kleontas A. Post-lobectomy pulmonary artery stump thrombosis: how dangerous is it? Ann Thorac Surg. 2011;91:e44.

    Article  PubMed  Google Scholar 

  14. Kwek BH, Wittram C. Postpneumonectomy pulmonary artery stump thrombosis: CT features and imaging follow-up. Radiology. 2005;237:338–41.

    Article  PubMed  Google Scholar 

  15. Schiller VL, Gray RK. Causes of clot in the pulmonary artery after pneumonectomy. AJR Am J Roentgenol. 1994;163:744–5.

    Article  CAS  PubMed  Google Scholar 

  16. Takahashi T, Yokoi K, Mori K, Miyazawa N. Clot in the pulmonary artery after pneumonectomy. AJR Am J Roentgenol. 1993;161:1110.

    Article  CAS  PubMed  Google Scholar 

  17. Ohira S, Doi K, Okawa K, Matsushiro T, Yaku H. Surgical removal of extensive left pulmonary vein stump thrombus after pulmonary lobectomy: a rare cause of acute cerebral embolism. Ann Thorac Surg. 2013;96:e135-6.

    Article  PubMed  Google Scholar 

  18. Rubins J, Unger M, Colice GL, American College of Chest Physicians. Follow-up and surveillance of the lung cancer patient following curative intent th erapy: ACCP evidence-based clinical practice guideline (2nd edition). Chest. 2007;132:355S–67S.

    Article  PubMed  Google Scholar 

  19. Manabe S, Oshima Y, Nakano M, Fujii T, Maehara T, Nitta K, et al. Renal infarction in a patient with pulmonary vein thrombosis after left upper lobectomy. Case Rep Nephrol Urol. 2014;4:103–8.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nagaoka E, Yano M, Sugano T, Miyamoto T. Thrombus in the left superior pulmonary vein after left upper pulmonary lobectomy. J Thorac Cardiovasc Surg. 2008;135:709–10.

    Article  PubMed  Google Scholar 

  21. Gual-Capllonch F, Teis A, Palomeras E. Pulmonary vein spontaneous echocontrast and stroke after pulmonary lobectomy. J Clin Ultrasound. 2013;41:321–2.

    Article  PubMed  Google Scholar 

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Correspondence to Hidemi Suzuki.

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Yamamoto, T., Suzuki, H., Nagato, K. et al. Is left upper lobectomy for lung cancer a risk factor for cerebral infarction?. Surg Today 46, 780–784 (2016). https://doi.org/10.1007/s00595-015-1233-0

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  • DOI: https://doi.org/10.1007/s00595-015-1233-0

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