Perioperative lung injury

acute exacerbation of idiopathic pulmonary fibrosis and acute interstitial pneumonia after pulmonary resection

Yasushi Hoshikawa, Takashi Kondo

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14 Citations (Scopus)

Abstract

The mortality rate after surgical resection for lung cancer has been reported to range between 1% and 3%, with 30% caused by acute exacerbation of idiopathic pulmonary fibrosis (IPF) or acute interstitial pneumonia (AIP). Approximately 20% of patients with IPF have lung cancer, while 2% to 4% of lung cancer patients have IPF. The incidence of postoperative acute exacerbation of IPF is about 20%. Some investigations in Japan revealed that 10% to 17% of lung cancer patients undergoing lung resection, who have not been diagnosed with IPF preoperatively, have localized-usual interstitial pneumonia (Lo-UIP) lesions. Approximately 20% of patients with Lo-UIP show postoperative acute exacerbation, while about 0.5% of those without Lo-UIP develop AIP after surgery. There is no confirmed treatment or prophylaxis. Most patients who develop postoperative acute exacerbation or AIP are treated with methylpredonisolone (1,000 mg/day x 3 days), but the mortality rate is 50% or greater. We emphasize that more efforts should be made to develop strategies to prevent postoperative acute exacerbation of IPF and AIP.

Original languageEnglish
Pages (from-to)757-762
Number of pages6
JournalNippon Geka Gakkai zasshi
Volume105
Issue number12
Publication statusPublished - 01-01-2004

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Idiopathic Pulmonary Fibrosis
Acute Lung Injury
Interstitial Lung Diseases
Lung
Lung Neoplasms
Mortality
Japan

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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abstract = "The mortality rate after surgical resection for lung cancer has been reported to range between 1{\%} and 3{\%}, with 30{\%} caused by acute exacerbation of idiopathic pulmonary fibrosis (IPF) or acute interstitial pneumonia (AIP). Approximately 20{\%} of patients with IPF have lung cancer, while 2{\%} to 4{\%} of lung cancer patients have IPF. The incidence of postoperative acute exacerbation of IPF is about 20{\%}. Some investigations in Japan revealed that 10{\%} to 17{\%} of lung cancer patients undergoing lung resection, who have not been diagnosed with IPF preoperatively, have localized-usual interstitial pneumonia (Lo-UIP) lesions. Approximately 20{\%} of patients with Lo-UIP show postoperative acute exacerbation, while about 0.5{\%} of those without Lo-UIP develop AIP after surgery. There is no confirmed treatment or prophylaxis. Most patients who develop postoperative acute exacerbation or AIP are treated with methylpredonisolone (1,000 mg/day x 3 days), but the mortality rate is 50{\%} or greater. We emphasize that more efforts should be made to develop strategies to prevent postoperative acute exacerbation of IPF and AIP.",
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N2 - The mortality rate after surgical resection for lung cancer has been reported to range between 1% and 3%, with 30% caused by acute exacerbation of idiopathic pulmonary fibrosis (IPF) or acute interstitial pneumonia (AIP). Approximately 20% of patients with IPF have lung cancer, while 2% to 4% of lung cancer patients have IPF. The incidence of postoperative acute exacerbation of IPF is about 20%. Some investigations in Japan revealed that 10% to 17% of lung cancer patients undergoing lung resection, who have not been diagnosed with IPF preoperatively, have localized-usual interstitial pneumonia (Lo-UIP) lesions. Approximately 20% of patients with Lo-UIP show postoperative acute exacerbation, while about 0.5% of those without Lo-UIP develop AIP after surgery. There is no confirmed treatment or prophylaxis. Most patients who develop postoperative acute exacerbation or AIP are treated with methylpredonisolone (1,000 mg/day x 3 days), but the mortality rate is 50% or greater. We emphasize that more efforts should be made to develop strategies to prevent postoperative acute exacerbation of IPF and AIP.

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