Jasna Špiček Macan

Profilaksa poslijeoperacijske atrijske fibrilacije i resekcija pluća – naša iskustva sa 608 uzastopnih bolesnika

Postoperative atrial fibrillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Therefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. This period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it. Patients having had atrial fibrillation before the surgery and patients with cardiac pacemaker were excluded from the trial. Other patients were divided into three groups: patients with some kind of antiarrhythmic therapy before and continued after the surgery; patients with diltiazem prophylaxis; and patients without any antiarrhythmic prophylaxis. The data collected were statistically analyzed. We found no statistically significant difference in the incidence of postoperative atrial fibrillation among the groups (p<0.05).

Radical surgery for esophageal cancer: our experience and analysis of risk factors for perioperative mortality: A-652

Radical operative therapy for esophageal cancer is usually connected with a significant mortality and morbidity. Purpose of this study is analysis of potential risk factors for mortality after radical surgery for esophageal cancer and presentation of our experience with this kind of surgery. There were 65 patients undergone radical surgery for esophageal cancer from the June 2003 to the April 2004 in our University Hospital for Chest Diseases. We analyzed as mortality risk factors: sex, age, albumin, aspartate transaminase, alanine transaminase, gamma glutamyl transferase, creatinine, hemoglobin, leucocytes, fibrinogene, prothrombine time, activated partial thromboplastine time, forced expiratory volume in the first second, vital pulmonary capacity, diffusion capacity for carbon monoxide (all preoperative), duration of surgery, perioperative infused fluid volume, perioperative transfusion, duration and stay in ICU. In our study perioperative mortality was 15.38%. Incidence of complications: pulmonary 44.61%, cardiac 6.15%, and surgical 27.69%. There were no statistically significant differences between groups of patients connected with most of analyzed factors. The most important finding is positive correlation of level of gamma glutamyl transpherase with perioperative mortality (p=0.012 for gamma glutamyl transferase >38 U/L, and p=0.017 for gamma glutamyl transferase >76 U/L-Fishers 2x2 test). Among the analyzed factors, only factor of potential prognostic importance for patients undergoing radical surgery for esophageal cancer could be the level of gamma glutamyl transferase. Reference: 1. Liu JF, Watson DI, Devitt PG, et al. Risk factor analysis of post-operative mortality in oesophagectomy. Dis Esophagus 2000 ; 13(2): 130-135.