[Pneumonectomy in a case of chronic hemodialysis]

A 60-year-old male was referred to our hospital due to a well-delineated tumor (4 x 4 x 3 cm) in the left hilar region demonstrated by chest X-ray examination. Bronchofiberscopic biopsy showed evidence of well moderately differentiated epidermoid carcinoma. Since the tumor infiltrated to a part of the pericardium, left pneumonectomy and partial resection of pericardium were performed. The disease was p-T2, N1, M0, and state II. Anemia was corrected with Erythropoietin, and hemodialysis was performed for 3 consecutive days before operation. Hemodialysis 3 times per week was initiated from 2 days after operation. Hyperkalemia was successfully treated by GI therapy (continuous intravenous infusion of glucose+insulin). His postoperative course was good without bleeding and infection. He was discharged 37 days after operation and has been observed on an outpatient basis. With an increased and aging patients on chronic hemodialysis, the operations for various malignant tumors have been increasing. However, there are few reports on operation for lung cancer and no report on pneumonectomy in such patients in Japan. We performed pneumonectomy for lung cancer detected in a patient on chronic hemodialysis for 4 years and obtained good results.