ABSTRACT【Background】The number of patients with lung cancer undergoing hemodialysis is increasing owing to an aging population. Outcomes following pulmonary resection in patients on hemodialysis are known to show a high rate of complications and poor prognosis. In patients with serious complications or poor general health, sublobar resection may be performed empirically. This study examined the perioperative complications and outcomes of patients with lung cancer undergoing hemodialysis. 【Methods】We retrospectively reviewed 1643 patients who underwent pulmonary resection for primary lung cancer at our institution between 2008 and 2018. Among these, 15 patients were undergoing maintenance hemodialysis at the time of surgery. The clinicopathological characteristics and clinical information of these patients were evaluated. 【Results】The hemodialysis group had a higher percentage of diabetes than the no hemodialysis group. Three patients (20%) underwent wedge resection, three (20%) underwent segmentectomy, and nine (60%) underwent lobectomy. Patients underwent hemodialysis the day after surgery, with the aim to remove fluid aggressively. Ten patients (67%) were able to dehydrate to preoperative body weight levels or less. Thirteen (87%) patients had pathological stage I and six (40%) experienced postoperative complications; however, their 90-day mortality rate was 0%. The percentage of sublobar resection tended to be higher than previously reported. The 5-year overall survival and recurrence-free survival rates were 80.0% and 66.7%, respectively in the 15 patients. 【Conclusion】Surgical complications may be tolerated in patients on hemodialysis who undergo lung resection if surgical procedures are appropriately selected and strict perioperative management is performed.
MATSUMOTO et al. (Mon,) studied this question.