Retrospective Evaluation of Patients with a Diagnosis of Primary Lung Cancer Who Underwent Resection with One-Lung Ventilation

Abstract

INTRODUCTION[|]Lung cancer is still the leading cause of cancer-related death and the incidence continues to increase. The development of one-lung ventilation (OLV) techniques has provided new surgical alternatives. The aim of this study was to investigate the demographic characteristics, anesthetic approaches, and factors that affected the prognosis of patients who underwent OLV in the treatment of lung cancer.[¤]METHODS[|]With the approval of the ethics committee, the records of 114 patients who underwent a lobectomy or pneumonectomy with OLV for primary lung cancer were retrospectively reviewed. The age; sex; American Society of Anesthesiologists (ASA) score; comorbid diseases; operation type; complications; the quantity of fluid and blood given; the preoperative, peroperative, and postoperative hemogram and blood gas values; and the rate of postoperative transfer to the intensive care unit (ICU) were investigated.[¤]RESULTS[|]The mean age of the patients was 56.35+-12.42 years; 89 (78%) were male and 25 (22%) were female. It was observed that 75 (65.8%) of the patients were smokers. An ASA classification of I-II was seen in 59 patients (51.75%), and an ASA classification of III-IV was noted in 55 patients (48.25%). Hypertension, diabetes mellitus, and chronic obstructive pulmonary disease were the most commonly seen comorbid diseases. The number of patients who received ICU care was 29 (25.43%). Of the admitted patients, 19 (65.5%) were ASA III-IV and 10 (34.5%) were ASA I-II; 19 (65.5%) were intubated and 10 (34.5%) were extubated. In all, 97 (85%) cases were a lobectomy and 17 (15%) cases were pneumonectomy. Twenty (20.6%) of the lobectomy patients and 9 (52.9%) of the pneumonectomy patients were taken to the ICU. It was determined that the age, comorbidities, ASA score, and complications were greater in the ICU patients, as well as the duration of anesthesia and OLV. There were a total of 10 (8%) cases with prolonged air leak, bronchopleural fistula, hemorrhage, or pulmonary edema complications.[¤]DISCUSSION AND CONCLUSION[|]It was concluded that a careful preoperative evaluation, surgical and anesthetic approach, and postoperative care are important to minimize the risk factors and improve the prognosis of thoracic surgery patients. These include bringing the lung function to the best possible state and assessing patient age, ASA score, comorbid diseases, operation type and anesthetic applications.[¤]

Keywords

• anesthesia
• one-lung ventilation; primary lung cancer.