title: Video-assisted thoracoscopic lobectomy for non-small cell lung cancer: a morbidity limiting approach in a patient on chronic hemodialysis and double agent antiplatelet therapy.
abstract: Patients with end-stage renal disease on hemodialysis undergoing surgery for lung cancer represent a high-risk group because of electrolyte imbalance, anemia, hemodynamic instability, bleeding tendency, and immunocompromised state. We describe a patient on hemodialysis with three lung adenocarcinoma of the right lower lobe as an incidental finding during the clinical course of a myocardial infarction treated with drug-eluting stent implantation and double-agent antiplatelet therapy. Considering patient comorbidities, we decided to perform a right lower lobectomy and complete lymph node dissection by a minimally invasive technique. In our experience, the thoracoscopic approach allowed us to perform lobectomy with complete lymph nodes dissection without morbidity. The use of ultrasound scalpel permits a complete lymph node dissection minimizing bleeding even in a double antiplatelet therapy patient.
authors.affiliation: Thoracic Surgery Operative Unit, S.Orsola Malpighi Hospital, University of Bologna, Via Massarenti 9, Bologna, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Caroli
authors.forename: Giampiero
authors.initials: G
authors.lastname: Dolci
authors.forename: Andrea
authors.initials: A
authors.lastname: Dell'Amore
authors.forename: Nizar
authors.initials: N
authors.lastname: Asadi
authors.forename: Domenico
authors.initials: D
authors.lastname: Greco
authors.forename: Ammari
authors.initials: A
authors.lastname: Chadi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bini
authors.forename: Franco
authors.initials: F
authors.lastname: Stella
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008168:Lung / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D009017:Morbidity; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011013:Pneumonectomy / Q000379:methods*; D006435:Renal Dialysis; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed
chemical_list: D010975:Platelet Aggregation Inhibitors