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Ann Thorac Surg 2001;71:435-438
© 2001 The Society of Thoracic Surgeons

Original article: general thoracic

Complications associated with pulmonary resection in lung cancer patients on dialysis

Masanori Tsuchida, MDa, Yasushi Yamato, MDa, Tadashi Aoki, MDa, Takehiro Watanabe, MDa, Takehisa Hashimoto, MDa, Hirohiko Shinohara, MDa, Jun-ichi Hayashi, MDa

a Department of Thoracic and Cardiovascular Surgery, Niigata University School of Medicine, Asahimachi, Japan

Accepted for publication August 1, 2000.

Address reprint requests to Dr Tsuchida, Department of Thoracic and Cardiovascular Surgery, Niigata University School of Medicine, 1-757 Asahimachi 951-8510, Japan
e-mail: kentsuchi{at}hotmail.com

Background. There are few studies available investigating the perioperative problems experienced by lung cancer patients on dialysis undergoing pulmonary resection.

Methods. A retrospective review of 7 patients on dialysis undergoing pulmonary resection for lung cancer was performed.

Results. The patient population consisted of 7 men, with a mean age of 59.9 years. The underlying kidney disease was glomerulonephritis in 5 patients and nephrosclerosis in 2. The mean levels of blood urea nitrogen and serum creatinine were 70.7 mg/dL and 9.4 mg/dL, respectively. Histologic diagnoses were adenocarcinoma in 2 patients and squamous cell carcinoma in 5. Standard lobectomy with lymph node dissection was performed in all cases. There was one operation related death due to pulmonary edema and subsequent development of pneumonia. There were two cases of sputum retention and four of hyperkalemia. One patient died of cerebral bleeding that occurred during dialysis 2 months postoperatively.

Conclusions. In patients on dialysis who undergo pulmonary resection, there is a high incidence of pulmonary complications, in addition to hyperkalemia, hemodynamic instability, and a tendency for postoperative dialysis-associated bleeding.




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