TY - JOUR
T1 - Left upper lobectomy is a risk factor for cerebral infarction after pulmonary resection
T2 - a multicentre, retrospective, case–control study in Japan
AU - Committee for Patient Safety, Quality Management of Japanese Association for Chest Surgery
AU - Matsumoto, Keitaro
AU - Sato, Shuntaro
AU - Okumura, Meinoshin
AU - Niwa, Hiroshi
AU - Hida, Yasuhiro
AU - Kaga, Kichizo
AU - Date, Hiroshi
AU - Nakajima, Jun
AU - Usuda, Jitsuo
AU - Suzuki, Makoto
AU - Souma, Takahiro
AU - Tsuchida, Masanori
AU - Miyata, Yoshihiro
AU - Takeshi, Nagayasu
N1 - Publisher Copyright:
© 2020, Springer Nature Singapore Pte Ltd.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - 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.
AB - 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.
KW - Cerebral infarction
KW - Lobectomy
KW - Lung cancer
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U2 - 10.1007/s00595-020-02032-4
DO - 10.1007/s00595-020-02032-4
M3 - Article
C2 - 32556550
AN - SCOPUS:85086597311
SN - 0941-1291
VL - 50
SP - 1383
EP - 1392
JO - Surgery Today
JF - Surgery Today
IS - 11
ER -