Postoperative outcomes of pulmonary resection in patients with non small-cell lung cancer with chronic kidney disease: a retrospective study.

IF 1.6 4区 医学 Q2 SURGERY
Yoshihito Iijima, Takaki Mizoguchi, Masahito Ishikawa, Shun Iwai, Nozomu Motono, Hidetaka Uramoto
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引用次数: 0

Abstract

Purpose: To investigate the impact of chronic kidney disease (CKD) on perioperative and long-term outcomes of pulmonary resection in patients with lung cancer.

Methods: Data from 331 patients who underwent pulmonary surgery for non-small-cell Lung cancer associated with CKD between 2016 and 2020 were analyzed. Patients were categorized based on preoperative reduced renal function (estimated glomerular filtration rate [eGFR] < 45 mL/min/1.73m2 [CKD grade ≥ G3b]). Patients with (n = 20) and without (n = 311) CKD were compared based on their clinicopathological characteristics and outcomes.

Results: Grades ≥ 2 and ≥ 3 postoperative pulmonary complications (PPCs) in the Clavien-Dindo classification and postoperative air leaks were common in the CKD group (p = 0.015, 0.005, and 0.025, respectively). The duration of drainage and hospital stay was long (p = 0.003, and p = 0.040, respectively). Kaplan-Meier curves showed a poor prognosis with regard to the overall survival (p = 0.022) and disease-free survival (p = 0.018) in the CKD group. A multivariate analysis confirmed that CKD with an eGFR < 45 mL/min/1.73 m2 was a significant risk factor for grade ≥ 3 PPCs (p = 0.037).

Conclusions: CKD with an eGFR < 45 mL/min/1.73 m2 involves various perioperative risks; therefore, care must be taken in intraoperative and perioperative management, and long-term collaboration with a nephrologist even before surgery is necessary.

非小细胞肺癌合并慢性肾脏疾病患者肺切除术的术后疗效:一项回顾性研究
目的:探讨慢性肾脏疾病(CKD)对肺癌患者肺切除术围手术期及远期预后的影响。方法:分析2016年至2020年期间331例接受肺部手术的非小细胞肺癌合并CKD患者的数据。根据术前肾功能降低(估计肾小球滤过率[eGFR] 2 [CKD分级≥G3b])对患者进行分类。根据CKD患者的临床病理特征和结果对有CKD患者(n = 20)和无CKD患者(n = 311)进行比较。结果:Clavien-Dindo分级≥2级和≥3级术后肺部并发症(PPCs)和术后漏气在CKD组较为常见(p分别为0.015、0.005和0.025)。引流时间长,住院时间长(p = 0.003, p = 0.040)。Kaplan-Meier曲线显示CKD组的总生存期(p = 0.022)和无病生存期(p = 0.018)预后较差。一项多变量分析证实,伴有eGFR 2的CKD是3级以上PPCs的重要危险因素(p = 0.037)。结论:伴有eGFR 2的CKD存在多种围手术期风险;因此,在术中和围术期管理中必须注意,甚至在手术前也必须与肾病专家长期合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Surgery Today
Surgery Today 医学-外科
CiteScore
4.90
自引率
4.00%
发文量
208
审稿时长
1 months
期刊介绍: Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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