title: Inhaled tiotropium to prevent postoperative cardiopulmonary complications in patients with newly diagnosed chronic obstructive pulmonary disease requiring lung cancer surgery.
abstract: OBJECTIVE
  A new diagnosis of chronic obstructive pulmonary disease is often made during the evaluation of patients requiring lung cancer surgery. The objective of the present study was to evaluate the clinical effects of inhaled tiotropium on the postoperative cardiopulmonary complications in patients with untreated chronic obstructive pulmonary disease requiring lung cancer surgery.
  
  
  METHODS
  A retrospective study involving 104 consecutive patients with moderate to severe chronic obstructive pulmonary disease who underwent a lobectomy for lung cancer at two specialized thoracic centers between April 2008 and October 2011 was performed. The results were compared between patients who did and did not receive inhaled tiotropium during the perioperative period. The primary endpoint was the incidence of postoperative cardiopulmonary complications. The postoperative white blood cell counts and C-reactive protein levels as biomarkers of inflammation were also examined.
  
  
  RESULTS
  The incidence of postoperative cardiopulmonary complications was significantly lower in the tiotropium group than in the control group (18 vs. 48 %, P = 0.001). Patients in the tiotropium group also showed significantly lower white blood cell counts and C-reactive protein levels postoperatively.
  
  
  CONCLUSIONS
  Inhaled tiotropium treatment during the perioperative period had a prophylactic effect on postoperative cardiopulmonary complications in patients with newly diagnosed chronic obstructive pulmonary disease requiring lung cancer surgery.
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 (L5) Yamadaoka, Suita, Osaka, 565-0871, Japan, nojirit@thoracic.med.osaka-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nojiri
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeda
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakagiri
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shintani
authors.forename: Masato
authors.initials: M
authors.lastname: Minami
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012120:Respiration Disorders / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide