EARLY COMPLICATIONS FOLLOWING ANATOMIC LUNG RESECTIONS--EXPERIENCE OF A THORACIC SURGICAL ONCOLOGY UNIT.

AIM: To analyze the medical and socioeconomic impact of the complications of anatomic lung resections performed at the Thoracic Surgery Unit of the Iasi Regional Cancer Institute. METHODS: This retrospective study included patients who underwent anatomic lung resections between January 2013 and August 2015. RESULTS: Over this interval a total of 172 major lung resections were performed: 31 (18.02%) pneumonectomies, 5 (2.91%) bilobectomies, and 136 (79.06%) lobectomies. Complications occurred in 36 patients, including bronchial stump fistula in 7 patients (4.06%), bronchopneumonia (9/5.23%), pleural empyema without bronchoscopically documented bronchial stump fistula (1/0.58%), chylothorax (1/0.58%), postoperative arrhythmia (3/1.74%), early postoperative stroke (1/0.58%), prolonged air leak (requiring hospital stay longer than 14 days) (11/6.38%), and postoperative hemothorax requiring reintervention (3/1.74%). Secondary to complications, a number of 3 (1.74%) patients died early postoperatively. CONCLUSIONS: The incidence of immediate and early postoperative complications is comparable to those reported by other authors.

Epidemiological evaluation of the outcomes after video-assisted thoracoscopic talcage in neoplastic pleurisy.

AIM: Clinical-epidemiological investigations for further assessing the importance of video-assisted thoracoscopy in the treatment y of patients with neoplastic pleurisy. MATERIALS AND METHODS: The researches included a group of 72 patients (31.9% men and 68.1% women aged 31-81 years, mean age ± 60 years) with neoplastic pleurisy who underwent pleural symphysis by video-assisted thoracoscopic talcage. For statistical-mathematical processing and interpretation the Pearson correlation index with the level of significance at p = 0.05 and highly significant at p < 0.005 was used. RESULTS: Neoplastic pleurisy prevalently affected the age groups 51-80 years (84.9%). Dyspnea was present in all cases, and patient history at the time of admission revealed 14 conditions, of which 25% were lung cancers. Macroscopically nodular and vegetative tumors were found in 66.7% of cases. An amount of 1000-2000 ml of pleural fluid was found in 44.5% of the cases and a serocitrin appearance in 50%. In 23.6% of the cases cytology results were positive for malignancy and in 13.8% suspicious. In 65.2% of the cases the pleural fluid was exudative and anatomopathology was suggestive of adenocarcinoma in 34.7% of the cases and breast cancer in 18%. The prevalence of recurrences varied from 1 month to more than 7 months, with 36.4% for 1-2 months. CONCLUSIONS: The obtained additional data support the important role of pleural symphysis by video-assisted thoracoscopic talcage in the patients with neoplastic pleurisy.

Clinical-epidemiological study on the incidence of postoperative complications after pulmonary resection for lung cancer.

AIM: To determine the relationship between the characteristics of a group of lung cancer patients, lung cancer surgeries, and the incidence of early and/or late postoperative complications. MATERIAL AND METHODS: The study included a group of 115 lung cancer patients aged 40 to 85 years, 76.5% men, 60.91% living in urban areas, who received surgical treatment in the interval January 2013-August 2014. Data were collected from electronic medical records and survey sheets and processed and interpreted using Pearson correlation index (p-value of 0.05 was considered statistically significant and of <0.005 highly statistically significant), and chi2, y, 1c = 25% tests. All statistical analyses were performed using the SPSS statistical software package version 13.0. RESULTS: Of the 115 patients 7.8% were in the 40-50 years age group and 87.8% in the 51-75 years age group (p < or = 0.001). Most patients were males (76.5%, p < 0.001), and 60.9% of the patients were living in urban areas (p < or = 0.05). The difference in the prevalence of smokers (76.5%) vs. non smokers (23.5%) was highly statistically significant (p < 0.005). Active smoking of one pack of cigarettes per day for more than 10 years was recorded in 54.8%. The presence of co morbidities (17 events) and the distribution of neoplastic lesions in the five anatomical areas required the performance of lobectomies, bilobectomies or pneumectomies. The incidence of early (14 entities) and late postoperative complications (7 entities) depended on patient's general condition, nature of co morbidities, location and stage of neoplastic lesions, and surgical complexity. CONCLUSIONS: Lung cancer, in various locations and stages, most commonly affected males aged 40-85 years, from urban areas, smokers, with various co morbidities. Surgeries performed in these patients were often laborious and with a relatively low incidence of postoperative complications.