Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection.
OBJECTIVE
Acute exacerbation (AE) of idiopathic interstitial pneumonia (IP) is a potentially fatal postoperative complication following lung cancer resection. Postoperative pyothorax (PP) following development of a bronchopleural fistula (BPF) after lung surgery induces continuous inflammation and may affect the occurrence of AE. We investigated the relationship between AE and PP in patients who underwent pulmonary resection for lung cancer.


METHODS
A total of 941 patients who underwent lung resection due to primary lung cancer from 2006 to 2015 at our hospital were investigated.


RESULTS
Of the 941 enrolled patients, 137 (14.6 %) had idiopathic IP and were predominantly male (p < 0.01). Pathological stage Ia and adenocarcinoma were observed at significantly high rates in the non-IP group (p < 0.01). Patients with IP showed a tendency for a higher percentage of PP (p = 0.054). Of the 137 patients with IP, 17 (12.4 %) showed postoperative AE. Furthermore, PP was observed in three cases in the AE(+) group and two in the AE(-) group. PP had a correlation with a significantly higher incidence of AE (p = 0.007).


CONCLUSIONS
PP was found to be a significant risk factor for postoperative AE in lung cancer patients undergoing a pulmonary resection. Since IP itself is likely a risk factor for PP, prevention of BPF is important for patients with IP, as it can lead to PP.
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Satoru
S
Kobayashi
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan. karube@dokkyomed.ac.jp.
Yoko
Y
Karube
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Morimichi
M
Nishihira
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Takashi
T
Inoue
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Osamu
O
Araki
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Sumiko
S
Maeda
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Tetsu
T
Sado
Department of Cardiovascular and Thoracic Surgery, Dokkyo Koshigaya Hospital, Koshigaya, Japan.
Yuji
Y
Matsumura
Department of General Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0294, Japan.
Masayuki
M
Chida
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016724:Empyema, Pleural / Q000150:complications*; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000209:etiology*; D015994:Incidence; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors
Acute exacerbation; Interstitial pneumonia; Lung cancer; Pyothorax