Acute Exacerbation of Idiopathic Interstitial Pneumonia Following Lung Surgery in 3 of 68 Consecutive Patients: A Retrospective Study
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概要
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Background Acute exacerbation (AE) of idiopathic interstitial pneumonia (IIP) is occasionally observed after lung surgery. However, the risk of lung surgery in patients with IIPs is not yet clearly known. Subjects and Methods We conducted a retrospective study of consecutive patients who underwent lung surgery for cancer or for the diagnosis of interstitial pneumonia (IP) between 2000 and 2006. Patients who developed AE following the lung operation were assessed. Results The data of 68 consecutive patients (males: 56, females: 12) with IP who underwent lung surgery were analyzed. The lung surgery included lobectomy for lung cancer in 48 patients [idiopathic pulmonary fibrosis (IPF) 31, non-IPF 17], and lung biopsy in 20 patients [IPF 8, non-specific interstitial pneumonia (NSIP) 8, unclassified 4]. Three patients with IPF (4.4% in total) developed AE after the operation (2 lobectomy, 1 biopsy). The triggers of AE were considered to be prolonged ventilation at a large tidal volume with oxygen supplementation at a high concentration. At the time of the AE, the extent of parenchymal involvement on the HRCT images was greater on the non-operated side. All three patients died of respiratory failure 12 to 82 days after the onset of AE despite corticosteroid therapy. Conclusion It is essential to be aware of the risk of AE of IPF following lung operation. Intraoperative respiratory management, such as oxygen supplementation at a high concentration and/or prolonged mechanical ventilation are likely possible etiologic factors.
著者
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Fujii Takeshi
Department of Cardiology, Nihon University Surugadai Hospital
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Sakamoto Susumu
Department of Respiratory Medicine, Toho University Omori Medical Center
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Homma Sakae
Department Of Respiratory Medicine Toho University Medical Center
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Mun Mingyon
Department of Thoracic Surgery, Toranomon Hospital, Japan
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Kurosaki Atsuko
Department of Radiology, Toranomon Hospital, Japan
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Yoshimura Kunihiko
Department of Respiratory Medicine, Toranomon Hospital, Japan
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Mun Mingyon
Department Of Thoracic Surgery Toranomon Hospital
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Homma Sakae
Department Of Respiratory Medicine Respiratory Center
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Yoshimura Kunihiko
Department Of Respiratory Medicine Respiratory Center Toranomon Hospital
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Kurosaki Atsuko
Department Of Diagnostic Radiology Toranomon Hospital
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Sakamoto Susumu
Department Of Cardiology Akashi Medical Center
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Fujii Takeshi
Department Of Applied Biological Science Faculty Of Science And Technology Science University Of Tok
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Homma Sakae
Department of Respiratory Medicine, Toho University School of Medicine, Japan
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Sakamoto Susumu
Department of Respiratory Medicine, Toho University School of Medicine, Japan
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