Læknablaðið - 15.04.2010, Blaðsíða 17

FRÆÐIGREINAR
RANNSÓKNIR
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Initial evaluation of the patient with lung cancer: symptoms,
signs, laboratory tests, and paraneoplastic syndromes: ACCP
evidenced-based clinical practice guidelines (2nd edition).
Chest 2007; 132(3 Suppl):149S-160S.
Postoperative complications following lobectomy for lung cancer in lceland
during 1999-2008
Objective: Non small cell lung cancer (NSCLC) is the
second most common cancer in lceland. We studied the
indications and surgical outcome of lobectomy for NSCLC
in lceland.
Materials and methods: 213 consecutive patients
underwent lobectomy for NSCLC between 1999 and
2008. Data on indications, histology, TNM-stage and
complications were analysed, and logistic regression used
to assess outcome predictors.
Results: The majority of patients (60%) were referred
because of symptoms, whereas 40% were asymptomatic.
Adenocarcinoma (62%) and squamous cell carcinoma
(29%) were the most frequent histological types. Operative
staging showed that 59.6% of cases were stage 1,17.8%
were stage II, 7% were stage IIIA and 14.6% were stage
IIIB or IV. Mediastinoscopy was performed in 13.6% of
cases. Mean operative time was 128 min., operative
bleeding 580 ml and median hospital stay 10 days. Sixteen
patients (7.5%) had major complications and 36 (17.5%)
had minor complications, such as atrial fibrillation and
pneumonia. Twelve patients required reoperation, most
often due to bleeding, but two had empyema and one
had a bronchopleural fistula. Older patients with high ASA
scores and extensive smoking history were at increased
risk for complications. No patient died within 30 days of
surgery whereas two (0,9%) died within 90 days of surgery.
Conclusions: The results of lobectomy for NSCLC in
lceland are excellent in relation to operative mortality and
short term complications.
Skuladottir R, Oskarsdottir GN, Isaksson HJ, Jonsson J, Thorsteinsson H, Gudbjartsson T.
Postoperative complications following lobectomy for lung cancer in lceland during 1999-2008. Icel Med J 2010; 96:243-9.
Key words: Lung cancer, lobectomy, surgery, indications, complications, operative mortality.
Correspondence: Tómas Guðbjartsson, tomasgud@landspitali.is
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Barst: 4. október 2009, - samþykkt til birtingar: 25. janúar 2010
Hagsmunatengsl: Engin
LÆKNAblaðið 2010/96 249