Related Experiment Video
Updated: May 2, 2026

Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Prophylaxis for acute exacerbation of interstitial pneumonia after lung resection
Hiroyuki Ito1, Haruhiko Nakayama2, Tomoyuki Yokose3
1Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan h-ito@kcch.jp.
Background And Purpose:
Acute exacerbation of interstitial pneumonia is a life-threatening complication after lung cancer surgery. Dorsal subpleural fibrotic changes occupying 3 or more segments of both lower lobes on high-resolution computed tomography indicate a very high risk. We conducted a prospective phase II study to assess the efficacy of prophylactic treatment.
Methods:
Patients with lung cancer underwent high-resolution computed tomography preoperatively to assess the risk of acute exacerbations of interstitial pneumonia. Before induction of general anesthesia, high-risk patients received 125 mg of methylprednisolone as an intravenous bolus and sivelestat sodium hydrate 300 mg ·day(-1) as a continuous intravenous infusion. From January 2010 through August 2011, a total of 327 patients underwent surgery for lung cancer, and 31 (9.5%) were enrolled.
Results:
There was no case of acute exacerbation. No adverse events were associated with prophylaxis. Usual interstitial pneumonia was confirmed histopathologically in 25 (80.6%) patients. Four (12.9%) patients had major complications. Usual interstitial pneumonia was diagnosed postoperatively in 4 (1.4%) of 327 patients who did not meet the inclusion criteria, and 1 of these patients died due to acute exacerbation of occult interstitial pneumonia.
Conclusion:
Perioperative use of sivelestat sodium hydrate and low-dose methylprednisolone may be useful as prophylaxis for acute exacerbation of interstitial pneumonia.
Related Concept Videos
Pneumothorax-II
Clinical Manifestations:
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia I: Introduction
Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...

