Keitaro Matsumoto1, Shuntaro Sato2, Meinoshin Okumura3, Hiroshi Niwa4, Yasuhiro Hida5, Kichizo Kaga5, Hiroshi Date6, Jun Nakajima7, Jitsuo Usuda8, Makoto Suzuki9, Takahiro Souma10, Masanori Tsuchida11, Yoshihiro Miyata12, Nagayasu Takeshi13. 1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. 2. Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan. 3. Toneyama Hospital, Toyonaka-shi, Osaka, Japan. 4. Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan. 5. Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 6. Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 7. Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan. 8. Department of Thoracic Surgery, Nippon Medical School, Tokyo, Japan. 9. Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan. 10. Division of Quality and Patient Safety, Chiba University Hospital, Chiba, Japan. 11. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 12. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan. 13. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. nagayasu@nagasaki-u.ac.jp.
Abstract
PURPOSE: The anatomical site of resected lobes may influence postoperative cerebral infarction. The objective of the current study was to determine if left upper pulmonary lobectomy is a risk factor for postoperative cerebral infarction. METHODS: This was a retrospective case-control study in patients undergoing pulmonary lobectomy from 2004 to 2013 in Japan. We retrospectively identified 610 patients from 153 institutions who had developed postoperative cerebral infarction following pulmonary lobectomy. The control group consisted of 773 patients who underwent lobectomy without cerebral infarction during a randomly selected single month in 2009 at the same institutions. RESULTS: Factors associated with cerebral infarction were age [10-year intervals, odds ratio (OR): 1.46; 95% confidence interval (CI): 1.23-1.73; p < 0.001], male sex (OR 1.92; 95% CI 1.29-2.86; p = 0.001), presence of comorbidities (OR 1.82; 95% CI 1.35-2.44; p < 0.001), perioperative anti-platelet or anti-coagulant drug use (OR 1.71; 95% CI 1.20-2.45; p = 0.003), and lobectomy. Subgroup analyses revealed that cerebral infarction was strongly associated with left upper lobectomy. CONCLUSIONS: Our findings suggest that left upper lobectomy is associated with a higher risk of cerebral infarction than other types of lobectomy, particularly in the early postoperative period.
PURPOSE: The anatomical site of resected lobes may influence postoperative cerebral infarction. The objective of the current study was to determine if left upper pulmonary lobectomy is a risk factor for postoperative cerebral infarction. METHODS: This was a retrospective case-control study in patients undergoing pulmonary lobectomy from 2004 to 2013 in Japan. We retrospectively identified 610 patients from 153 institutions who had developed postoperative cerebral infarction following pulmonary lobectomy. The control group consisted of 773 patients who underwent lobectomy without cerebral infarction during a randomly selected single month in 2009 at the same institutions. RESULTS: Factors associated with cerebral infarction were age [10-year intervals, odds ratio (OR): 1.46; 95% confidence interval (CI): 1.23-1.73; p < 0.001], male sex (OR 1.92; 95% CI 1.29-2.86; p = 0.001), presence of comorbidities (OR 1.82; 95% CI 1.35-2.44; p < 0.001), perioperative anti-platelet or anti-coagulant drug use (OR 1.71; 95% CI 1.20-2.45; p = 0.003), and lobectomy. Subgroup analyses revealed that cerebral infarction was strongly associated with left upper lobectomy. CONCLUSIONS: Our findings suggest that left upper lobectomy is associated with a higher risk of cerebral infarction than other types of lobectomy, particularly in the early postoperative period.
Entities:
Keywords:
Cerebral infarction; Lobectomy; Lung cancer