Alan Stolz, Jan Simonek, Tomas Harustiak, Robert Lischke, Jan Schutzner, Pavel Pafko
Department of Thoracic Surgery, University Hospital Motol, Charles University, Prague, Czech Republic.
J Surg Oncol. 2009 Jan 1;99(1):38-41. doi: 10.1002/jso.21181.
The impact of chemotherapy on postoperative complications after pneumonectomy remains unclear, and the procedure is often considered as potentially dangerous.
This retrospective review of prospectively collected data included 269 patients operated from January 1, 1998 through December 31, 2007. Group 1 included patients those who received preoperative chemotherapy (PCT) and pneumonectomy (54 patients, 20%), and group 2 included patients who underwent pneumonectomy alone (215 patients, 80%).
Overall 30- and 90-day mortality rates were 5.9% and 8.9%, respectively. Postoperative mortality at 30 days was 5.6% in group 1 and 6% in group 2 (P = 0.16), and 11.1% for group 1 and 8.3% in group 2 at 90 days (P = 0.8). Incidence of postoperative respiratory failure was 3.7% in group 1 and 3.2% in group 2 (P = 0.62); incidence of empyema was 5.5% in group 1 and 2.8% in group 2 (P = 0.1). Incidence of bronchopleural fistula (BPF) was 3.7% in group 1 and 2.8% in group 2 (P = 0.55); risk of BPF was higher following right pneumonectomy (6.1%) versus left pneumonectomy (0%, P = 0.003).
PCT does not significantly increase postoperative morbidity and early mortality after pneumonectomy in our experience.
化疗对肺切除术后并发症的影响仍不明确，且该手术常被认为具有潜在危险性。
本项对前瞻性收集数据的回顾性研究纳入了1998年1月1日至2007年12月31日期间接受手术的269例患者。第1组包括接受术前化疗（PCT）及肺切除术的患者（54例，20%），第2组包括仅接受肺切除术的患者（215例，80%）。
总的30天和90天死亡率分别为5.9%和8.9%。第1组30天术后死亡率为5.6%，第2组为6%（P = 0.16）；第1组90天为11.1%，第2组为8.3%（P = 0.8）。术后呼吸衰竭发生率第1组为3.7%，第2组为3.2%（P = 0.62）；脓胸发生率第1组为5.5%，第2组为2.8%（P = 0.1）。支气管胸膜瘘（BPF）发生率第1组为3.7%，第2组为2.8%（P = 0.55）；右肺切除术后BPF风险较高（6.1%），而左肺切除术后为0%（P = 0.003）。
根据我们的经验，术前化疗不会显著增加肺切除术后的发病率和早期死亡率。
Zotero 插件