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Postoperative ischemic bronchitis after lymph node dissection and primary lung cancer resection.
Lotfi Benhamed1, Jocelyn Bellier, Clément Fournier
1Department of Thoracic Surgery, Albert Calmette Hospital, University Hospital of Lille, Lille, France. mohamedlotfi-benhamed@chru-lille.fr
The Annals of Thoracic Surgery
|January 25, 2011
Summary
Postoperative ischemic bronchitis (POIB) occurred in 3.21% of lung cancer patients after lymph node dissection. Early diagnosis via bronchoscopy and hyperbaric oxygen therapy show promise for managing this condition.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Oncology
Background:
- Lung cancer treatment often involves systematic lymph node dissection (LND).
- Postoperative ischemic bronchitis (POIB) is a potential complication following lung cancer surgery.
- The incidence and clinical presentation of POIB require further investigation.
Purpose of the Study:
- To determine the incidence and symptoms of postoperative ischemic bronchitis (POIB) after lung cancer surgery with LND.
- To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) as a treatment for POIB.
Main Methods:
- A cohort of 1,071 patients undergoing non-small cell lung cancer resection and LND were studied.
- Systematic fiberoptic bronchoscopy was performed between postoperative days 7 and 12.
- Clinical and biological signs of POIB were analyzed, with HBOT initiated upon diagnosis.
Main Results:
- POIB was diagnosed in 34 patients (3.21%), with a mean onset of 8 days post-surgery.
- The majority of POIB cases (80%) were asymptomatic; 62% involved bronchial stumps.
- Hyperbaric oxygen therapy involved a mean of 14 sessions, with 18% experiencing worsening requiring rescue therapy.
Conclusions:
- The clinical presentation of POIB is often subtle, underscoring the need for systematic fiberoptic bronchoscopy, particularly in high-risk patients.
- Hyperbaric oxygen therapy may serve as a beneficial adjunctive treatment for managing ischemic bronchitis post-lung cancer surgery.
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