Risk factors associated with postoperative pulmonary complications following oncological surgery

Ozdilekcan, Cigdem; ÜÇGÜL, Emel; BERKTAŞ, Bahadır M.; OK, Uğur; SONGÜR, Necla; DİNÇ, Meral

Risk factors associated with postoperative pulmonary complications following oncological surgery

Çiğdem ÖZDİLEKCAN, (Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, Ankara, Türkiye)

Necla SONGÜR, (Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, Ankara, Türkiye)

Bahadır M. BERKTAŞ, (Sağlık Bakanlığı, Atatürk Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları ve Göğüs Cerrahisi Kliniği, Ankara, Türkiye)

Meral DİNÇ, (Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, Ankara, Türkiye)

Emel ÜÇGÜL, (Gazi Üniversitesi, Tıp Fakültesi, Medikal Onkoloji Anabilim Dalı, Ankara, Türkiye)

Uğur OK (Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, Ankara, Türkiye)

Tüberküloz ve Toraks

2 0

Yıl: 2004 Cilt: 52 Sayı: 3 Sayfa Aralığı: 248 - 255 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Risk factors associated with postoperative pulmonary complications following oncological surgery

Öz:

Çalışmanın amacı, bir onkolojik cerrahi merkezinde farklı tiple elektif cerrahiler uygulanan hastalarda postoperatif pulmoner komplikasyonlar (PPC) 'in sıklığının saptanması ve bunlarla ilişkili risk faktörlerinin belirlenmesidir. Doksan beş erişkin hasta bir yıl süreyle prospeküf olarak çalışmaya alındı. Çalışmaya alınan grupta, pulmoner komplikasyonların belirlenmesinde yaş, cinsiyet, vücut kitle indeksi, eşlik eden akciğer hastalıkları (kronik obstrüktüf akciğer hastalığı, astım, bronşektazi, restriküf akciğer hastalığı), operasyonun yeri ve tipi, "The American Society of Anesthesiologists (ASA)" sınıflandırmasına göre fiziksel durum, fizik muayene ve akciğer grafi bulguları, solunum fonksiyon testleri, anestezi süresi ve tipi, cerrahi insizyonun yeri ve uzunluğu, operasyon sonrası nazogastrik tüp varlığı dikkate alındı. Çalışma grubunun PPC oranı %40 (38/95) olarak hesaplandı. En sık gözlenen komplikasyonlar atelektazi ve bronkospazmdı (%13.7). Çok değişkenli analizde tüm risk faktörleri içinde; abdominal insizyon (p= 0.008), anestezi süresi (p= 0.0001) ue $FEV_1$< %50 değerlerinin (p= 0.007) pulmoner komplikasyonları diğer değişkenlerden bağımsız olarak etkilediği saptandı. Diğer cerrahi girişimlere göre, çalışma grubunda pulmoner komplikasyon oranının daha yüksek olduğu görüldü. Bu sonuç, kanser hastalarına uygulanan majör rezeksiyon cerrahi seçeneklerinin varlığı ile açıklanabilmektedir. Yine de cerrahi süresinin kısaltılması ve seçilmiş hasta gruplarında genel anesteziden kaçınılmasının PPC riskini azaltacağı kanısındayız.

Anahtar Kelime: İleriye dönük çalışma Risk faktörleri Akciğer hastalıkları Ameliyat sonrası komplikasyonlar

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Onkolojik cerrahi sonrası gelişen postoperatif pulmoner komplikasyonlarla ilişkili risk faktörleri

Öz:

The purpose of our study was to determine the incidence of different postoperative pulmonary complications (PPCs) and their associated risk factors in patients who have undergone various elective surgical procedures in an oncological surgery center. Ninety five adult patients were studied prospectwely for one year period. For the study group, predictors of pulmonary complications of interest were determined as age, gender, body mass index, co morbid conditions (preexisting history of chronic obtructiue pulmonary disease, asthma, bronchiectasis, restrictive lung disease), site and type of the operation, smoking history, The American Society of Anesthesiologists (ASA) physical status, physical examination and chest X- Ray findings, pulmonary function tests, type and duration of anesthesia, surgical incision site and length and presence of nasogastric tube suction. The PPC rate of our study group was 40% (38/95). Atelectasis and bronchospasm were the most frequently obserued PPCs (13.7%) Among all the risk factors taken into consideration, only three were found to be significant independent predictors of pulmonary complications according to multiuariate analysis as follows: incision location concerning abdomen (p= 0.008), duration of anesthesia per hour (p= 0.0001), values of $FEV_1$ < 50% (p= 0.007). Our data repealed that the incidence of PPCs was high in our study group when compared to results of general population. Application of major resection surgeries for cancer patients can be an explanation for this result. Shortening the duration of surgery, auoiding general aneasthesia in selected group of patients may reduce the risk of PPCs.

Anahtar Kelime: Postoperative Complications Prospective Studies Risk Factors Lung Diseases

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Bibliyografik

1. Wong DH, Weber EC, Schell MJ, et al. Factors associated with postoperative pulmonary complications in patients with severe chronic obstructive pulmonary disease. Anesth Analg 1995; 80: 276-84.
2. Hall JC, Talala RA, Mander J. A multivariate analysis of the risk of pulmonary complications after laparatomy. Chest 1991; 99: 923-7.
3. Kroenke K, Lawrence VA, Theroux JF, et al. Postoperative complications after thoracic and major abdominal surgery in patients with and without obstructive lung disease. Chest 1993; 104: 1445-51.
4. Pasteur W. Active lobar collapse of the lung after abdominal operations. Lancet 1910; 2: 1080-3.
5. Gass GD, Olsen GN. Preoperative pulmonary fuction testing to predict postoperative morbidity and mortality. Chest 1986; 89: 127-35.
6. Ferguson MK. Postoperative assessment of pulmonary risk. Chest 1999; 115:58-63.
7. Powell CA, Caplan CE. Pulmonary function tests in preoperative pulmonary evaluation. Clin Chest Med 2001; 22: 703-14.
8. Dripps DR, Lamont A, Eckenfoff JE. The role of anesthesia in surgical mortality. Jama 1961; 178: 261-6.
9. European Respiratory Society. Standardised Lung Function testing. Lung volumes and forced ventilatory flows. Eur Respir J 1993; 6(Suppl 6): 5-40.
10. Hughes JMB, Pride NB. Lung Function Tests. London: WB Saunders, 2000: 4-25.
11. Hosmer DW, Lemeshow S. Applied logistic regression. New York: John Wiley, 1989: 140-5.
12. Brooks JA, Brunn DNS. Predictors of postoperative pulmonary complications following abdominal surgery. Chest 1997; 111: 564-71.
13. Platell C, Hall JC. Atelectasis after abdominal surgery. J Am Coll Surg 1997; 185:584-92.
14. Kocabaş A, Kara K, Özgür O, et al. Value of preoperative spirometry to predict postoperative pulmonary complications. Respir Med 1996; 90: 25-33.
15. Lawrence WA, Dhanda R, Hilsenbeck SG, Page CP. Risk of pulmonary complications after elective abdominal surgery. Chest 1996; 110: 744 -50.
16. Smetena GW. Preoperative pulmonary assessment of the older adult. Clin Geriatr Med 2003; 19: 35-55.
17. Fernandez ALG, Pereira EDB, Ancao MS. Evaluation of predict risk factors for pulmonary complications in patients who were undergoing elective upper abdominal surgery. Am J Respir Crit Care Med 1995; 151: 490.
18. Oleh TC, Hnatiuk MC, Corcoran PC, et al. Spirometry in surgery for anterior mediastinal masses. Chest 2001; 120: 1152-6.
19. Velanovich V. The effects of age, gender, race and concomitant disease on postoperative complications. R Coll Surg Edinb 1993; 38:225-30.
20. Ferguson MK, Martin TR, Reeder LB, Olak J. Mortality after esophagectomy: Risk factor analysis. World J Surg 1997; 21: 599-604.

APA	Ozdilekcan C, SONGÜR N, BERKTAŞ B, DİNÇ M, ÜÇGÜL E, OK U (2004). Risk factors associated with postoperative pulmonary complications following oncological surgery. , 248 - 255.
Chicago	Ozdilekcan Cigdem,SONGÜR Necla,BERKTAŞ Bahadır M.,DİNÇ Meral,ÜÇGÜL Emel,OK Uğur Risk factors associated with postoperative pulmonary complications following oncological surgery. (2004): 248 - 255.
MLA	Ozdilekcan Cigdem,SONGÜR Necla,BERKTAŞ Bahadır M.,DİNÇ Meral,ÜÇGÜL Emel,OK Uğur Risk factors associated with postoperative pulmonary complications following oncological surgery. , 2004, ss.248 - 255.
AMA	Ozdilekcan C,SONGÜR N,BERKTAŞ B,DİNÇ M,ÜÇGÜL E,OK U Risk factors associated with postoperative pulmonary complications following oncological surgery. . 2004; 248 - 255.
Vancouver	Ozdilekcan C,SONGÜR N,BERKTAŞ B,DİNÇ M,ÜÇGÜL E,OK U Risk factors associated with postoperative pulmonary complications following oncological surgery. . 2004; 248 - 255.
IEEE	Ozdilekcan C,SONGÜR N,BERKTAŞ B,DİNÇ M,ÜÇGÜL E,OK U "Risk factors associated with postoperative pulmonary complications following oncological surgery." , ss.248 - 255, 2004.
ISNAD	Ozdilekcan, Cigdem vd. "Risk factors associated with postoperative pulmonary complications following oncological surgery". (2004), 248-255.

APA	Ozdilekcan C, SONGÜR N, BERKTAŞ B, DİNÇ M, ÜÇGÜL E, OK U (2004). Risk factors associated with postoperative pulmonary complications following oncological surgery. Tüberküloz ve Toraks, 52(3), 248 - 255.
Chicago	Ozdilekcan Cigdem,SONGÜR Necla,BERKTAŞ Bahadır M.,DİNÇ Meral,ÜÇGÜL Emel,OK Uğur Risk factors associated with postoperative pulmonary complications following oncological surgery. Tüberküloz ve Toraks 52, no.3 (2004): 248 - 255.
MLA	Ozdilekcan Cigdem,SONGÜR Necla,BERKTAŞ Bahadır M.,DİNÇ Meral,ÜÇGÜL Emel,OK Uğur Risk factors associated with postoperative pulmonary complications following oncological surgery. Tüberküloz ve Toraks, vol.52, no.3, 2004, ss.248 - 255.
AMA	Ozdilekcan C,SONGÜR N,BERKTAŞ B,DİNÇ M,ÜÇGÜL E,OK U Risk factors associated with postoperative pulmonary complications following oncological surgery. Tüberküloz ve Toraks. 2004; 52(3): 248 - 255.
Vancouver	Ozdilekcan C,SONGÜR N,BERKTAŞ B,DİNÇ M,ÜÇGÜL E,OK U Risk factors associated with postoperative pulmonary complications following oncological surgery. Tüberküloz ve Toraks. 2004; 52(3): 248 - 255.
IEEE	Ozdilekcan C,SONGÜR N,BERKTAŞ B,DİNÇ M,ÜÇGÜL E,OK U "Risk factors associated with postoperative pulmonary complications following oncological surgery." Tüberküloz ve Toraks, 52, ss.248 - 255, 2004.
ISNAD	Ozdilekcan, Cigdem vd. "Risk factors associated with postoperative pulmonary complications following oncological surgery". Tüberküloz ve Toraks 52/3 (2004), 248-255.