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[Intensive care unit admissions following lobectomy or sublobar resections for non-small cell lung cancer].

https://arctichealth.org/en/permalink/ahliterature123917
Source
Laeknabladid. 2012 May;98(5):271-5
Publication Type
Article
Date
May-2012
Author
Tomas Andri Axelsson
Martin Ingi Sigurdsson
Asgeir Alexandersson
Hunbogi Thorsteinsson
Gudmundur Klemenzson
Steinn Jonsson
Tomas Gudbjartsson
Author Affiliation
Department of Cadiothoracic Surgery, University of Iceland, Iceland. tomasgud@landspitali.is
Source
Laeknabladid. 2012 May;98(5):271-5
Date
May-2012
Language
Icelandic
Geographic Location
Iceland
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - surgery
Female
Humans
Iceland
Intensive Care Units
Length of Stay
Lung Neoplasms - surgery
Male
Middle Aged
Patient Admission
Pneumonectomy - adverse effects
Postoperative Complications - etiology - therapy
Retrospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Following resection for non-small cell lung cancer (NSCLC), patients are usually admitted to the post-anesthesia care unit (PACU)for a few hours before admission to a general ward (GW). However, some patients need ICU-admission, either immediately post-surgery or from the PACU or GW. The aim of this study was to investigate the indications and risk factors for ICU-admission.
A retrospective study of 252 patients who underwent lobectomy, wedge resection or segmentectomy for NSCLC in Iceland during 2001-2010. Data was retrieved from medical records and patients admitted to the ICU compared to patients not admitted.
Altogether 21 patients (8%) were admitted to the ICU, median length-of-stay being one day (range 1-68). In 11 cases (52%) the reasons for admission were intraoperative problems, usually hypotension or excessive bleeding. Ten patients were admitted from the GW (n=4) or PACU (n=6), due to hypotension (n=4), heart and/or respiratory failure (n=4) and reoperation for bleeding (n=2). There were three ICU-readmissions. Patients admitted to the ICU were six years older (p=0.004) and more often had chronic obstructive pulmonary disease and/or coronary artery disease. Tumor size, pTNM-stage, length of operation and the ratio of patients receiving TEA (thoracic epidural anaesthesia) were similar between groups. Over two-thirds of the ICU-patients had minor complications and around half had major complications, compared to 30% and 4%, respectively, for controls.
ICU-admissions are infrequent following non-pneumonectomy lung resections for NSCLC, these patients being older with cardiopulmonary comorbidities. In half of the cases, admission to the ICU directly follows surgery and ICU-readmissions are few.
PubMed ID
22647404 View in PubMed
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Resection rate and outcome of pulmonary resections for non-small-cell lung cancer: a nationwide study from Iceland.

https://arctichealth.org/en/permalink/ahliterature124315
Source
J Thorac Oncol. 2012 Jul;7(7):1164-9
Publication Type
Article
Date
Jul-2012
Author
Hunbogi Thorsteinsson
Asgeir Alexandersson
Gudrun N Oskarsdottir
Rut Skuladottir
Helgi J Isaksson
Steinn Jonsson
Tomas Gudbjartsson
Author Affiliation
Faculty of Medicine, and †Department of Cardiothoracic Surgery, University of Iceland, Reykjavik, Iceland.
Source
J Thorac Oncol. 2012 Jul;7(7):1164-9
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - secondary - surgery
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - mortality - pathology - surgery
Carcinoma, Squamous Cell - mortality - secondary - surgery
Female
Follow-Up Studies
Humans
Iceland
Lung Neoplasms - mortality - pathology - surgery
Male
Medical Records
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Pneumonectomy
Postoperative Complications
Prognosis
Retrospective Studies
Survival Rate
Abstract
The proportion of patients with non-small-cell lung cancer (NSCLC) who undergo surgery with curative intent is one measure of effectiveness in treating lung cancer. To the best of our knowledge, surgical resection rate (SRR) for a whole nation has never been reported before. We studied the SRR and surgical outcome of NSCLC patients in Iceland during a recent 15-year period.
This was a retrospective study of all pulmonary resections performed with curative intent for NSCLC in Iceland from 1994 to 2008. Information was retrieved from medical records and from the Icelandic Cancer Registry. Patient demographics, postoperative tumor, node, metastasis stage, overall survival, and complication rates were compared over three 5-year periods.
Of 1530 confirmed cases of NSCLC, 404 were resected, giving an SRR of 26.4%, which did not change significantly during the study period. Minor and major complication rates were 37.4% and 8.7%, respectively. Operative mortality rates were 0.7% for lobectomy, 3.3% for pneumonectomy, and 0% for lesser resection. Five-year survival after all procedures was 40.7% and improved from the first to the last 5-year period (34.8% versus 43.8%, p = 0.04). Five-year survival for stages I and II together was 46.8%, with no significant change in stage distribution between periods. Five-year survival after pneumonectomy was 22.0%, which was significantly lower than for lobectomy (44.6%) and lesser resection (40.7%) (p
Notes
Comment In: J Thorac Oncol. 2012 Jul;7(7):1067-822706606
PubMed ID
22592213 View in PubMed
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[Sublobar resection for non-small cell lung cancer in Iceland].

https://arctichealth.org/en/permalink/ahliterature134425
Source
Laeknabladid. 2011 May;97(5):303-8
Publication Type
Article
Date
May-2011
Author
Asgeir Alexandersson
Steinn Jonsson
Helgi J Isaksson
Tomas Gudbjartsson
Source
Laeknabladid. 2011 May;97(5):303-8
Date
May-2011
Language
Icelandic
Geographic Location
Iceland
Publication Type
Article
Keywords
Aged
Carcinoma, Non-Small-Cell Lung - mortality - surgery
Comorbidity
Female
Humans
Iceland
Kaplan-Meier Estimate
Lung Neoplasms - mortality - pathology - surgery
Male
Neoplasm Staging
Pneumonectomy - adverse effects - methods - mortality
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Abstract
A sublobar resection is performed on patients with non-small cell lung cancer (NSCLC) who are not candidates for a lobectomy due to reduced pulmonary function or comorbid disease. The aim of this study was to investigate the outcomes of these operations in Iceland.
A retrospective study of all patients with NSCLC who underwent wedge resection or segmentectomy with curative intent during 1994-2008. Data on indication, pathological TNM-stage, complications and overall survival was analyzed. All histological samples were re-evaluated.
Forty four patients underwent 42 wedge and 5 segmental resections (age 69.1 yrs, 55.3% female), with 38.3% of cases detected incidentally. The majority of patients (55.3%) had a history of coronary artery disease and 40.4% had chronic obstructive pulmonary disease. Mean operative time was 83 minutes (range 30-131), mean intraoperative bleeding was 260 ml (range 100-650) and median hospital stay was 9 days (range 4-24). Pneumonia (14.9%) and prolonged air leakage (12.8%) were the most common complications. Two patients had major complications and 36.2% stayed in the intensive care unit overnight. No deaths occurred within 30 days of surgery. Adenocarcinoma was the most common histological type (66.7%). Most cases were stage IA/IB (78.7%), 17.0% were stage IIA/IIB and 4.3% were stage IIIA. One and 5 year survival was 85.1% and 40.9% respectively.
In Iceland, both survival and complication rate after sublobar resection for NSCLC are comparable to results published for lobectomies, even though a higher percentage of patients have underlying cardiopulmonary disease.
PubMed ID
21586802 View in PubMed
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