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Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection

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Abstract

Objective

Acute exacerbation (AE) of idiopathic interstitial pneumonia (IP) is a potentially fatal postoperative complication following lung cancer resection. Postoperative pyothorax (PP) following development of a bronchopleural fistula (BPF) after lung surgery induces continuous inflammation and may affect the occurrence of AE. We investigated the relationship between AE and PP in patients who underwent pulmonary resection for lung cancer.

Methods

A total of 941 patients who underwent lung resection due to primary lung cancer from 2006 to 2015 at our hospital were investigated.

Results

Of the 941 enrolled patients, 137 (14.6 %) had idiopathic IP and were predominantly male (p < 0.01). Pathological stage Ia and adenocarcinoma were observed at significantly high rates in the non-IP group (p < 0.01). Patients with IP showed a tendency for a higher percentage of PP (p = 0.054). Of the 137 patients with IP, 17 (12.4 %) showed postoperative AE. Furthermore, PP was observed in three cases in the AE(+) group and two in the AE(−) group. PP had a correlation with a significantly higher incidence of AE (p = 0.007).

Conclusion

PP was found to be a significant risk factor for postoperative AE in lung cancer patients undergoing a pulmonary resection. Since IP itself is likely a risk factor for PP, prevention of BPF is important for patients with IP, as it can lead to PP.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan

    Satoru Kobayashi, Yoko Karube, Morimichi Nishihira, Takashi Inoue, Osamu Araki, Sumiko Maeda, Tetsu Sado & Masayuki Chida

  2. Department of Cardiovascular and Thoracic Surgery, Dokkyo Koshigaya Hospital, Koshigaya, Japan

    Yuji Matsumura

Authors
  1. Satoru Kobayashi
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  2. Yoko Karube
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  3. Morimichi Nishihira
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  4. Takashi Inoue
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  5. Osamu Araki
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  6. Sumiko Maeda
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  7. Tetsu Sado
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  8. Yuji Matsumura
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  9. Masayuki Chida
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Corresponding author

Correspondence to Yoko Karube.

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All authors declare that they have no conflicts of interest.

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Kobayashi, S., Karube, Y., Nishihira, M. et al. Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection. Gen Thorac Cardiovasc Surg 64, 476–480 (2016). https://doi.org/10.1007/s11748-016-0665-9

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  • DOI: https://doi.org/10.1007/s11748-016-0665-9

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