| Lung resection for non-small cell lung cancer after prophylactic coronary angioplasty and stenting: short- and long-term results. | |
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MedLine Citation:
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PMID: 22361679 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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L Voltolini; C Rapicetta; L Luzzi; P Paladini; C Ghiribelli; S Scolletta; M Fineschi; G Gotti |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Minerva chirurgica Volume: 67 ISSN: 0026-4733 ISO Abbreviation: Minerva Chir Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0400726 Medline TA: Minerva Chir Country: Italy |
Other Details:
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Languages: eng Pagination: 77-85 Citation Subset: IM |
Affiliation:
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Unit of Thoracic Surgery, University Hospital of Siena, Siena, Italy - voltoliniluca@yahoo.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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