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Life-threatening complications after pulmonary resection for lung cancer in patients on chronic hemodialysis

  • Kenji Tomizawa
  • Katsuaki Sato
  • Shuta Ohara
  • Toshio Fujino
  • Takamasa Koga
  • Masaya Nishino
  • Yoshihisa Kobayashi
  • Masato Chiba
  • Masaki Shimoji
  • Kenichi Suda
  • Toshiki Takemoto
  • Tetsuya MitsudomiEmail author
Original Article
  • 7 Downloads

Abstract

Purpose

The morbidity and mortality associated with lung cancer surgery in patients on chronic hemodialysis (CHD) is high; however, the relationship between the severity of postoperative complications and clinicopathological features is unclear.

Methods

Among 1214 consecutive patients who underwent pulmonary resection for primary lung cancer in our institute between 2004 and 2015, we identified 21 patients on CHD, who were the subjects of this study. Life-threatening postoperative complications were defined as grade 4 and 5 per the Clavien–Dindo classification.

Results

Fourteen (67%) of these 21 patients suffered postoperative complications, which were life threatening in 5. There was a higher frequency of interstitial pneumonia (IP) in the patients with life-threatening postoperative complications than in those with complications that were not life threatening (p = 0.032). The rates of acute exacerbation and 90-day mortality in the patients with IP were 50% and 75%, respectively. The overall survival (OS) rate of the patients with life-threatening postoperative complications was significantly lower than that of those with complications that were not life threatening (1- and 3-year OS rates: 40% and 0% vs. 80% and 57%, respectively, p = 0.001).

Conclusions

Postoperative mortality and morbidity were high in patients on CHD who underwent pulmonary resection, especially if they had coexisting IP. Although IP is not a contraindication to pulmonary resection, the surgical strategy for CHD patients with IP should be considered carefully.

Keywords

Lung cancer Chronic hemodialysis Interstitial pneumonia 

Notes

Compliance with ethical standards

Conflict of interest

We have no conflicts of interest to declare.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Kenji Tomizawa
    • 1
    • 2
  • Katsuaki Sato
    • 1
    • 2
  • Shuta Ohara
    • 1
  • Toshio Fujino
    • 1
  • Takamasa Koga
    • 1
  • Masaya Nishino
    • 1
  • Yoshihisa Kobayashi
    • 1
  • Masato Chiba
    • 1
  • Masaki Shimoji
    • 1
  • Kenichi Suda
    • 1
  • Toshiki Takemoto
    • 1
  • Tetsuya Mitsudomi
    • 1
    Email author
  1. 1.Division of Thoracic Surgery, Department of SurgeryKindai University Faculty of MedicineOsakasayamaJapan
  2. 2.Department of Thoracic SurgeryIzumi City General HospitalIzumiJapan

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