Acute interstitial pneumonia following surgery for primary lung cancer.
OBJECTIVE
Although acute interstitial pneumonia is a life-threatening complication following surgery for lung cancer, the cause and risk factors for acute interstitial pneumonia remain unknown. We conducted this study to determine the characteristics of acute interstitial pneumonia after pulmonary resection and to identify the risk factors for this disease.


METHODS
We experienced 16 (2.0%) cases of acute interstitial pneumonia among 822 patients who underwent pulmonary resection for primary lung cancer over a period of 12 years. We performed a retrospective analysis of these patients, comprising the patients' background, the operative procedure, the radiographic characteristics and the prognosis.


RESULTS
In all patients, the shadow appeared within 1 week after the operation. Twelve patients required mechanical ventilatory support due to the development of respiratory failure. The site of the tumor (right side), preoperative radiation or chemotherapy, pneumonectomy, blood transfusion, and intraoperative complication were independent risk factors for the incidence of acute interstitial pneumonia (P=0.001, 0.0484, 0.0012, 0.0002, 0.0003, respectively) in the multivariate analysis. Nine of the 16 patients died due to respiratory failure, resulting in a mortality rate of 56.3%. The maximum amount of lactate dehydrogenase (LDH) in the operative death patients was significantly higher than that in the survivors (472+/-138IU/l vs 257+/-79IU/l, respectively, P=0.0031).


CONCLUSIONS
We concluded that in order to reduce the incidence of acute interstitial pneumonia, it is necessary to perform careful postoperative management for patients who are male, have right lung disease, have undergone preoperative chemo or radiation therapy, or have undergone pneumonectomy.
Muraoka
Masashi
M
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. mmuraoka@oitakenbyo.jp
Tagawa
Tsutomu
T
Akamine
Shinji
S
Oka
Tadayuki
T
Tsuchiya
Tomoshi
T
Araki
Masato
M
Hayashi
Tomayoshi
T
Nagayasu
Takeshi
T
D000208:Acute Disease; D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012307:Risk Factors; D012737:Sex Factors