Background and objective: The left upper lobectomy as treatment for lung cancer has been identified as a risk factor for cerebral infarction. We analyzed cases of surgery for lung cancer to clarify factors that increase the risk for postoperative cerebral infarction. Methods: This study included patients with primary lung cancer who underwent lobectomy or segmentectomy with >ND1 lymph node dissection from 2008 to 2014 at Hachioji Medical Center of Tokyo Medical University. In total, 479 patients (294 males and 157 females) were examined. Cases of cerebral infarction occurring within 30 days of surgery were retrospectively studied. All surgeries were performed under mini-thoracotomy with thoracoscopy support. Vessels >7 mm in diameter were amputated using a linear stapler. Results: Cerebral infarction occurred in four male patients, representing 0.8% (4/479) of all lung cancers and 1.4% (4/294) of all male patients. Of these four patients, three were in their 60s (1.4% of 157 patients in their 60s) and one was in his 70s (0.5% of 215 patients in their 70s). Two cases involved adenocarcinomas, and two involved squamous cell carcinomas. One patient underwent right upper lobectomy, two underwent right lower lobectomy, and one underwent left upper lobectomy. The cerebral infarctions occurred in a branch of the vertebral artery. The pons was impaired in three cases, and the cerebellum was impaired in one. Three patients had pl2 disease, and one patient had pl3 disease. Operative time was 4–5 h in two cases, 5–6 h in one, and >6 h in one. Only pl factor significantly differed between patients with and without postoperative cerebral infarction. Conclusions: To prevent cerebral infarction, the following factors should be considered: preoperative smoking cessation, operative positioning to protect the vertebral artery, shortening of operative time, and stronger anticoagulant therapy for high-risk patients, such as those with past history of transient ischemic attack.
| Published in | Journal of Surgery (Volume 7, Issue 3) |
| DOI | 10.11648/j.js.20190703.13 |
| Page(s) | 63-66 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Cerebral Infarction, Lobectomy, Lung Cancer, Lymph Node Dissection, Pulmonary Vein Thrombosis
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APA Style
Hiroyuki Miura, Jun Miura, Hiroshi Hirano. (2019). Cerebral Infarction After Lobectomy for Lung Cancer. Journal of Surgery, 7(3), 63-66. https://doi.org/10.11648/j.js.20190703.13
ACS Style
Hiroyuki Miura; Jun Miura; Hiroshi Hirano. Cerebral Infarction After Lobectomy for Lung Cancer. J. Surg. 2019, 7(3), 63-66. doi: 10.11648/j.js.20190703.13
AMA Style
Hiroyuki Miura, Jun Miura, Hiroshi Hirano. Cerebral Infarction After Lobectomy for Lung Cancer. J Surg. 2019;7(3):63-66. doi: 10.11648/j.js.20190703.13
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Download@article{10.11648/j.js.20190703.13,
author = {Hiroyuki Miura and Jun Miura and Hiroshi Hirano},
title = {Cerebral Infarction After Lobectomy for Lung Cancer},
journal = {Journal of Surgery},
volume = {7},
number = {3},
pages = {63-66},
doi = {10.11648/j.js.20190703.13},
url = {https://doi.org/10.11648/j.js.20190703.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190703.13},
abstract = {Background and objective: The left upper lobectomy as treatment for lung cancer has been identified as a risk factor for cerebral infarction. We analyzed cases of surgery for lung cancer to clarify factors that increase the risk for postoperative cerebral infarction. Methods: This study included patients with primary lung cancer who underwent lobectomy or segmentectomy with >ND1 lymph node dissection from 2008 to 2014 at Hachioji Medical Center of Tokyo Medical University. In total, 479 patients (294 males and 157 females) were examined. Cases of cerebral infarction occurring within 30 days of surgery were retrospectively studied. All surgeries were performed under mini-thoracotomy with thoracoscopy support. Vessels >7 mm in diameter were amputated using a linear stapler. Results: Cerebral infarction occurred in four male patients, representing 0.8% (4/479) of all lung cancers and 1.4% (4/294) of all male patients. Of these four patients, three were in their 60s (1.4% of 157 patients in their 60s) and one was in his 70s (0.5% of 215 patients in their 70s). Two cases involved adenocarcinomas, and two involved squamous cell carcinomas. One patient underwent right upper lobectomy, two underwent right lower lobectomy, and one underwent left upper lobectomy. The cerebral infarctions occurred in a branch of the vertebral artery. The pons was impaired in three cases, and the cerebellum was impaired in one. Three patients had pl2 disease, and one patient had pl3 disease. Operative time was 4–5 h in two cases, 5–6 h in one, and >6 h in one. Only pl factor significantly differed between patients with and without postoperative cerebral infarction. Conclusions: To prevent cerebral infarction, the following factors should be considered: preoperative smoking cessation, operative positioning to protect the vertebral artery, shortening of operative time, and stronger anticoagulant therapy for high-risk patients, such as those with past history of transient ischemic attack.},
year = {2019}
}
TY - JOUR T1 - Cerebral Infarction After Lobectomy for Lung Cancer AU - Hiroyuki Miura AU - Jun Miura AU - Hiroshi Hirano Y1 - 2019/06/10 PY - 2019 N1 - https://doi.org/10.11648/j.js.20190703.13 DO - 10.11648/j.js.20190703.13 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 63 EP - 66 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20190703.13 AB - Background and objective: The left upper lobectomy as treatment for lung cancer has been identified as a risk factor for cerebral infarction. We analyzed cases of surgery for lung cancer to clarify factors that increase the risk for postoperative cerebral infarction. Methods: This study included patients with primary lung cancer who underwent lobectomy or segmentectomy with >ND1 lymph node dissection from 2008 to 2014 at Hachioji Medical Center of Tokyo Medical University. In total, 479 patients (294 males and 157 females) were examined. Cases of cerebral infarction occurring within 30 days of surgery were retrospectively studied. All surgeries were performed under mini-thoracotomy with thoracoscopy support. Vessels >7 mm in diameter were amputated using a linear stapler. Results: Cerebral infarction occurred in four male patients, representing 0.8% (4/479) of all lung cancers and 1.4% (4/294) of all male patients. Of these four patients, three were in their 60s (1.4% of 157 patients in their 60s) and one was in his 70s (0.5% of 215 patients in their 70s). Two cases involved adenocarcinomas, and two involved squamous cell carcinomas. One patient underwent right upper lobectomy, two underwent right lower lobectomy, and one underwent left upper lobectomy. The cerebral infarctions occurred in a branch of the vertebral artery. The pons was impaired in three cases, and the cerebellum was impaired in one. Three patients had pl2 disease, and one patient had pl3 disease. Operative time was 4–5 h in two cases, 5–6 h in one, and >6 h in one. Only pl factor significantly differed between patients with and without postoperative cerebral infarction. Conclusions: To prevent cerebral infarction, the following factors should be considered: preoperative smoking cessation, operative positioning to protect the vertebral artery, shortening of operative time, and stronger anticoagulant therapy for high-risk patients, such as those with past history of transient ischemic attack. VL - 7 IS - 3 ER -
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