术前贫血不影响肺癌患者术后早期结局。

Preoperative anaemia does not affect the early postoperative outcome in patients with lung cancer.

作者信息

Anile M, Venuta F, Diso D, Vitolo D, Longo F, De Giacomo T, Francioni F, Liparulo V, Ricella C, Ruberto F, Coloni G F

机构信息

Department of Thoracic Surgery, University of Rome La Sapienza, Rome, Italy.

出版信息

Minerva Chir. 2007 Dec;62(6):431-5.

PMID:18091652

Abstract

AIM

Several prognostic factors like age, gender, histology, stage, type of operation, associated disorders and administration of induction therapy have been evaluated to assess the risk of postoperative complications and outcome in patients with resectable lung cancer. Anemia is a frequent condition in this subset of patients being estimated up to 50%. The aim of this retrospective study was to evaluate the effect of preoperative anemia on early outcome after lung cancer resection.

METHODS

One-hundred thirty nine consecutive patients undergoing surgery for non small cell lung cancer were retrospectively considered. The mean age was 64.8+/-11.6 years. No patient received blood transfusions or administration of erythropoetin preoperatively. Overall, we performed 96 lobectomies, 14 pneumonectomies, 2 bilobectomies and 27 atypical resections. A subset of 27 patients (19.4%) (group I) had a preoperative value of Hb less than 12 g/dl (10.4+/-1.9 g/dL). Seven patients of them were stage IA (26%), 9 stage IB (33.3%), 2 stage IIA (7.4%), 6 stage IIB (22.2%), 2 stage IIIA (7.4%) and 1 stage IIIB (3.7%). Age, gender, stage, type of operation, induction chemotherapy, comorbidities were evaluated by univariate analysis comparing patients with and without preoperative anaemia. The two groups were homogenous regarding demographic characteristics.

RESULTS

Three patients (11.1%) in group I and 2 (1.8%) in group II required blood transfusions after surgery (P=0.01); 4 of them received pneumonectomy (P<0.0001). The overall morbidity was 17.9% (25/139); the most frequent complication was persistent air leakage, followed by retention of secretions. No statistically significant difference was observed between the 2 groups about early mortality (1 patient-3.7% in group I and 2 patients-1.8% in group II) and postoperative complications (5 patients-18.5% in group I and 20 patients-17.9% in group II).

CONCLUSION

Preoperative anaemia is not a risk factor for an increased rate of postoperative complications and should not be considered a contraindication to surgery.

摘要

目的

已对年龄、性别、组织学类型、分期、手术方式、相关疾病及诱导治疗的应用等多个预后因素进行评估，以评估可切除肺癌患者术后并发症风险及预后情况。贫血在这类患者中较为常见，估计发生率高达50%。本回顾性研究旨在评估术前贫血对肺癌切除术后早期预后的影响。

方法

回顾性分析139例连续接受非小细胞肺癌手术的患者。平均年龄为64.8±11.6岁。术前无患者接受输血或促红细胞生成素治疗。总体而言，我们进行了96例肺叶切除术、14例全肺切除术、2例双肺叶切除术和27例非典型切除术。27例患者（19.4%）（第一组）术前血红蛋白值低于12g/dl（10.4±1.9g/dL）。其中7例为ⅠA期（26%），9例为ⅠB期（33.3%），2例为ⅡA期（7.4%），6例为ⅡB期（22.2%），2例为ⅢA期（7.4%），1例为ⅢB期（3.7%）。通过单因素分析比较有和无术前贫血的患者，评估年龄、性别、分期、手术方式、诱导化疗、合并症情况。两组在人口统计学特征方面具有同质性。

结果

第一组3例患者（11.1%）和第二组2例患者（1.8%）术后需要输血（P=0.01）；其中4例接受了全肺切除术（P<0.0001）。总体发病率为17.9%（25/139）；最常见的并发症是持续性漏气，其次是分泌物潴留。两组在早期死亡率（第一组1例患者-3.7%，第二组2例患者-1.8%）和术后并发症（第一组5例患者-18.5%，第二组20例患者-17.9%）方面未观察到统计学显著差异。