Dejan Moskovljevic

Postoperative complications do not influence the pattern of early lung function recovery after lung resection for lung cancer in patients at risk

BackgroundThe pattern and factors influencing the lung function recovery in the first postoperative days are still not fully elucidated, especially in patients at increased risk.MethodsProspective study on 60 patients at increased risk, who underwent a lung resection for primary lung cancer. Inclusion criteria: complete resection and one or more known risk factors in form of COPD, cardiovascular disorders, advanced age or other comorbidities. Previous myocardial infarction, myocardial revascularization or stenting, cardiac rhythm disorders, arterial hypertension and myocardiopathy determined the increased cardiac risk. The severity of COPD was graded according to GOLD criteria. The trend of the postoperative lung function recovery was assessed by performing spirometry with a portable spirometer.ResultsCardiac comorbidity existed in 55%, mild and moderate COPD in 20% and 35% of patients respectively. Measured values of FVC% and FEV1% on postoperative days one, three and seven, showed continuous improvement, with significant difference between the days of measurement, especially between days three and seven. There was no difference in the trend of the lung function recovery between patients with and without postoperative complications. Whilst pO2 was decreasing during the first three days in a roughly parallel fashion in patients with respiratory, surgical complications and in patients without complications, a slight hypercapnia registered on the first postoperative day was gradually abolished in all groups except in patients with cardiac complications.ConclusionExtent of the lung resection and postoperative complications do not significantly influence the trend of the lung function recovery after lung resection for lung cancer.

Comparison of mediastinal lymph node status and relapse pattern in clinical stage IIIA non‐small cell lung cancer patients treated with neoadjuvant chemotherapy versus upfront surgery: A single center experience

In spite of the progress made in neoadjuvant therapy for operable non small‐cell lung cancer (NSCLC), many issues remain unsolved, especially in locally advanced stage IIIA.

Early postoperative changes in lung function after resection for lung cancer - do the complications have influence?

Method Sixty patients undergoing surgical resection (sublobar, lobectomy, and pneumonectomy) for non-small cell lung cancer were included in a prospective, single institution study. Sex, age, stage and type of lung cancer, comorbidities, preoperative values of lung function tests including DLCO and exercise test were analyzed. Postoperative complications were classified as surgical, respiratory and cardiovascular. FEV1 and FVC were measured on postoperative days 1, 3 and 7, regardless of postoperative complications. Results Study encompassed 60 patients (70% male, mean age 60.9 ± 8.4 and 30% female, mean age 56.9 ± 6.5). Mild degree of COPD was noted in 20% and moderate in 35% of patients, according to GOLD classification. All postoperative adverse events, not only major complications were recorded. Respiratory complications occurred in 20%, surgical in 41.7% and cardiac in 19% of patients. Measured postoperative values of FVC% and FEV1% on days 1, 3 and 7 after surgery shoved continuous improvement, with significant difference between the days of measurement, specially days 3 and 7. Values recorded on day 7 did not differ from ppo FEV1%. No difference in early postoperative trend of lung function recovery was noted between patients without and with postoperative complications. However, patients that developed respiratory complications showed significantly lower values of FEV1 and FVC on postoperative day 1. Conclusions Early lung function after resection for lung cancer shows significant improvement despite of postoperative complications.