[A review of Japanese literatures concerning surgery for lung cancer with idiopathic interstitial pneumonia].
OBJECTIVE
The aim of the present study is to investigate the perioperative management of acute exacerbation of idiopathic interstitial pneumonia (IIP) after pulmonary resection for lung cancer.


METHODS
We reviewed 5 Japanese literatures published from 1992 through 1998. The present study included 50 lung cancer patients with IIP, of which 3 were our cases and 47 were reported cases.


RESULTS
Within 30 days after operation, acute exacerbation of IIP occurred in 12 cases (24.0%). Preoperative profiles (gender, age, smoking status, respiratory function, pathologic stage) of the exacerbated cases did not differ from those of non-exacerbated cases. The mean intraoperative PaO2 of the exacerbated cases was significantly higher than that of non-exacerbated cases (224 +/- 45.6 Torr vs 120 +/- 41.2 Torr, p = 0.005). The rate of acute exacerbation increased with the extent of resection, that is 42.8% in pneumonectomy, 24.3% in lobectomy, and 0% in wedge resection although the difference was not significant. After acute exacerbation of IIP, all 12 cases were given high doses of steroids. However, 11 cases died due to the disease progression (mortality rate = 91.7%).


CONCLUSIONS
In order to establish the perioperative management for prevention of acute exacerbation of IIP, multi-institutional study is warranted on the basis of the present results (intraoperative FiO2, administration schedule of steroids etc).
Yano
T
T
Department of Thoracic Surgery, Nakatsu Municipal Hospital, Nakatsu, Japan.
Koga
T
T
Ninomiya
S
S
Taketomi
A
A
Yoshida
T
T
Matsumata
T
T
D000368:Aged; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000473:pathology / Q000517:prevention & control; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*