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Reoperation for postoperative bleeding following pulmonary resection: a report of a single-center experience

  • Motoki YanoEmail author
  • Hiroki Numanami
  • Takashi Akiyama
  • Rumiko Taguchi
  • Chihiro Furuta
  • Masayuki Haniuda
Original Article
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Abstract

Objective

The variety and incidence of postoperative complications seem to have changed with recent progress in thoracic surgery. This study attempted to improve our recognition of postoperative bleeding.

Methods

Among 1143 patients undergoing pulmonary resection for pulmonary nodules, ten underwent surgical treatment for postoperative bleeding. Clinical and pathologic data were analyzed. Additionally, the relationship between the bleeding point and an increased amount of drained bloody effusion before the second operation was analyzed.

Results

The bleeding point was recognized in eight cases: the intercostal artery (n = 4), the lung (n = 2), aberrant vessel of the apex of the lung (n = 1) and the bronchial artery (n = 1). The bleeding points were unknown in two cases in whom the decision to perform a second operation was delayed. Potential reasons or influential factors for bleeding were stapling complications (n = 4), low coagulation ability (n = 2) and intraoperative injury (n = 1). We experienced two cases in which intercostal arterial bleeding was induced by scratching the thoracic wall or the vertebra with the edge of the reinforced stapling line or the sharp edge of a broken staple at the first operation. We divided patients into three groups based on the interval between operations. Bleeding from the arteries seemed to show a higher rate of bleeding per hour than that from the lung parenchyma.

Conclusion

The bleeding points and speculated reasons for bleeding varied among patients. We were able to cure all ten cases. It might be dependent on the rapid decision of reoperation in cases with arterial bleeding was suspected.

Keywords

Reoperation Postoperative bleeding Pulmonary resection 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest in the present study.

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Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  1. 1.Division of Chest Surgery, Department of SurgeryAichi Medical UniversityNagakuteJapan

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