Document Detail

Lung resection for non-small cell lung cancer after prophylactic coronary angioplasty and stenting: short- and long-term results.
MedLine Citation:
PMID:  22361679     Owner:  NLM     Status:  In-Data-Review    
AIM: Recent studies have reported a high incidence of perioperative in-stent trombosis with myocardial infarction (MI), in patients undergoing non-cardiac surgery, early after coronary angioplasty and stenting. The short and long-term results of surgery for non-small cell lung cancer (NSCLC) after prophylatic coronary angioplasty and stenting were analyzed.
METHODS: Prospective collected data were examined for postoperative complications and long-term survival in 16 consecutive patients who underwent mayor lung resection for NSCLC after prophylactic coronary angioplasty and stenting for significant coronary artery disease , from 2001 to 2008. One and two non-drug-eluting stents were placed in 75% or (25% of the patient, respectively. All patients had four weeks of dual antiplatelet therapy, that was discontinued 5 days prior to surgery and replaced by low molecular weight heparin. Patients were keep sedated and intubated overnight, according to our protocol. RESULS:There were no postoperative deaths nor MI. A patient experienced pulmonary embolism with moderate troponin release and underwent coronary angiography that showed patency of the stent. Two patients developed postoperative bleeding complications haemothorax requiring a re-thoracotomy in 1, gastric bleeding requiring blood transfusion in 1. At the mean follow-up of 30 months (range 3-95), none of the patients showed evidence of myocardial ischemia, while 5 (31%) patients died, mostly (N.=4) due to distant metastasis. The five-year survival rate was 53%.
CONCLUSION: In contrast to previous reports, lung resection after prophylactic coronary angioplasty and stenting is a safe and effective treatment for NSCLC and myocardial ischemia. The application of a refined protocol could be the key factor for improved results.
L Voltolini; C Rapicetta; L Luzzi; P Paladini; C Ghiribelli; S Scolletta; M Fineschi; G Gotti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva chirurgica     Volume:  67     ISSN:  0026-4733     ISO Abbreviation:  Minerva Chir     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400726     Medline TA:  Minerva Chir     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  77-85     Citation Subset:  IM    
Unit of Thoracic Surgery, University Hospital of Siena, Siena, Italy -
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