Key result
Lung resection in hemodialysis patients carries ~64% morbidity despite zero operative mortality.
Why the study?
The clinical characteristics and postoperative outcomes of lung cancer patients on hemodialysis undergoing pulmonary resection were not well described.
Is pulmonary resection safe and effective for lung cancer patients on chronic hemodialysis?
Observational (n=22)
No
Is pulmonary resection safe and effective for lung cancer patients on chronic hemodialysis?
Pulmonary resection can be safely performed in lung cancer patients on chronic hemodialysis with appropriate perioperative management, yielding a 5-year survival rate of 36.2%.
High morbidity (63.6%) warrants careful selection for resection in hemodialysis patients; leaves open comparative effectiveness versus nonoperative strategies.
*Objective* . We retrospectively analyzed the clinical characteristics of the patients on hemodialysis who underwent pulmonary resection for lung cancers. *Methods* . Among 1969 patients who underwent pulmonary resections at our institution from December 1994 to December 2007, a total of 22 patients on hemodialysis (1.1%) were reviewed in this study. Male patients were 18 cases (81.8%), mean age 65.9 years. *Results* . Twenty patients underwent lobectomy, 1 underwent a wedge resection and 1 underwent a segmentectomy. The mean duration of pleural drainage and the hospital stay after the operation was 6.4±4.7 days and 16.5±5.1 days, respectively. The histologic diagnoses were squamous cell carcinoma in 12 patients, adenocarcinoma in 7, small cell carcinoma in 2 and adenosquamous carcinoma in 1. The distribution of pathological staging was IA in 8 cases, IB in 4, IIB in 5, IIIA in 3, and IIIB in 2. There was no operative and in-hospital mortality, whereas the overall morbidity rate was 63.6%. The recurrence within 1 year after the operation was observed in 3 cases (16.7%). The median disease free interval was 21 months, ranging from 6 to 94 months. Overall 5-year survival rate was 36.2%. *Conclusion* . In patients on hemodialysis who undergo pulmonary resection, there is a high incidence of pulmonary and cardiac complications. Careful postoperative management is mandatory during postoperative period.
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Takahama et al. (2009) conducted an observational in Lung cancer in patients on hemodialysis (n=22). Pulmonary resection was evaluated on Overall morbidity. Pulmonary resection in hemodialysis patients with lung cancer resulted in no operative mortality, a high overall morbidity rate of 63.6%, and an overall 5-year survival rate of 36.2%.
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