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Titolo:
Prediction of early bronchopleural fistula after pneumonectomy: A multivariate analysis
Autore:
Algar, FJ; Alvarez, A; Aranda, JL; Salvatierra, A; Baamonde, C; Lopez-Pujol, FJ;
Indirizzi:
Hosp Univ Reina Sofia, Serv Cirugia Torac, Dept Thorac Surg, Cordoba 14004, Spain Hosp Univ Reina Sofia Cordoba Spain 14004 rac Surg, Cordoba 14004, Spain
Titolo Testata:
ANNALS OF THORACIC SURGERY
fascicolo: 5, volume: 72, anno: 2001,
pagine: 1662 - 1667
SICI:
0003-4975(200111)72:5<1662:POEBFA>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
RISK-FACTORS; BRONCHOGENIC-CARCINOMA; LUNG-CANCER; MANAGEMENT; CLOSURE; RESECTION; SUTURE; STUMP;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Algar, FJ Hosp Univ Reina Sofia, Serv Cirugia Torac, Dept Thorac Surg, Avda MenendezPidal S-N, Cordoba 14004, Spain Hosp Univ Reina Sofia Avda Menendez Pidal S-N Cordoba Spain 14004
Citazione:
F.J. Algar et al., "Prediction of early bronchopleural fistula after pneumonectomy: A multivariate analysis", ANN THORAC, 72(5), 2001, pp. 1662-1667

Abstract

Background. The aim of this study was to determine independent risk factors for early bronchopleural fistula (BPF) after pneumonectomy and to assess the efficacy of bronchial coverage in preventing this complication. Methods. We reviewed 242 consecutive patients undergoing pneumonectomy forlung cancer. The bronchial stump was covered with autologous tissue in 178patients (74%). Perioperative data were recorded to identify risk factors of BPF by univariate and multivariate analyses. Results. Overall morbidity and mortality rates were 59% and 5.4% respectively. The incidence of BPF was 5.4%. By univariate analysis, patients with chronic obstructive pulmonary disease (COPD; p = 0.017), hyperglycemia (p = 0.003), hypoalbuminemia (p = 0.017), previous steroid therapy (p < 0.001), poor predicted postpneumonectomy forced expiratory volume in 1 second (FEV1; p = 0.012), long bronchial stumps (p < 0.001), and mechanical ventilation(p = 0.015), were related with higher risk of BPF. In the multiple logistic regression model, the independent risk factors of BPF were the bronchial stump coverage and length, side of pneumonectomy, predicted postpneumonectomy FEV, COPD, and mechanical ventilation. Conclusions. Bronchial stump coverage is highly recommended in all cases to minimize the risks of BPF. A shorter length of the bronchial stump and early extubation may prevent the development of BPF. Careful attention must be paid to those patients with COPD and poor predicted postpneumonectomy FEV1. (C) 2001 by The Society of Thoracic Surgeons.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 05:51:13