Portal de Periódicos da CAPES

Morbidity and mortality in a large series of surgical patients with pulmonary metastases of colorectal carcinoma: a prospective multicentre Spanish study (GECMP-CCR-SEPAR)

2013; Oxford University Press; Volume: 45; Issue: 4 Linguagem: Inglês

10.1093/ejcts/ezt459

1873-734X

Alberto Rodríguez-Fuster, José Belda-Sanchís, Rafel Aguiló, Raúl Embún Flor, Sergi Mojal, Sergi Call, Laureano Molins, Juan José Rivas de Andrés, J. Ruiz Zafra, C. Pagés Navarrete, J. de la Cruz Lozano, Juan José Rivas de Andrés, Raúl Embún Flor, J. Freixinet, M. Carbajo Carbajo, Carlos A. Rombolá, F. Heras, Laureano Molins, J Odriozola, Francisco Rivas Doyagüe, Alberto Rodríguez-Fuster, Emilio Canalís Arrayás, Mariano Garay, Sergi Call, E.F. Araújo, S. García Barajas, José María García-Prim, Diana Belkys Mujica González, Marcelo Barbosa Ramos, José Ramón Jarabo Sarceda, R. Peñalver Pascual, Gemma María Muñoz‐Molina, M. C. M. Fernandez, Beatriz de Olaiz, A. Arroyo Tristán, C. G. Franco, Richard Wins, Anna Arnau, Javier Mendez Padilla, Guillermo Carriquiry, M Rosenberg, David Smith,

Pancreatic and Hepatic Oncology Research

Little information is available on postoperative morbidity and mortality after pulmonary metastasectomy. We describe the postoperative morbidity and mortality in a large multicentre series of patients after a first surgical procedure for pulmonary metastases of colorectal carcinoma (CRC) and identify the pre- and intraoperative variables influencing the clinical outcome. A prospective, observational and multicentre study was conducted. Data were collected from March 2008 to February 2010. Patients were grouped into Groups A and B according to the presence or absence of postoperative complications. Variables in both groups were compared by univariate and multivariate analyses. P-values of <0.05 were considered statistically significant. A total of 532 patients (64.5% males) from 32 hospitals were included. The mean (SD) ages of both study groups were similar [68 (10) vs 67 (10) years, P = NS). A total of 1050 lung resections were performed (90% segmentectomies or wedge, n = 946 and 10% lobectomies or greater, n = 104). Group A included 83 (15.6%) patients who developed a total of 100 complications. These included persistent air leaks in 18, atelectasis in 13, pneumonia in 13, paralytic ileum in 12, arrhythmia in 9, acute respiratory distress syndrome in 4 and miscellanea in 31. Reoperation was performed in 5 (0.9%) patients due to persistent air leaks in 4 and lung ischaemia in 1. The mortality rate was 0.4% (n = 2). Causes of death were sepsis in 1 patient and ventricular fibrillation in 1. In the multivariate analysis, lobectomy or greater lung resection [odds ration (OR) 1.9, 95% confidence interval (95% CI) 1.04–3.3, P = 0.03], respiratory co-morbidity (OR 2.3, 95% CI 1.1–4.6, P = 0.01) and cardiovascular co-morbidity (OR 2, 95% CI 1–3.8, P = 0.02) were independent risk factors for postoperative morbidity. Video-assisted surgery vs thoracotomy showed a protective effect (OR 0.3, 95% CI 0.1–0.8, P = 0.01). The first episode of lung surgery for pulmonary metastases of CRC was associated with very low mortality and reoperation rates (<1%). The postoperative morbidity rate was 16%. Independent risk factors of postoperative morbidity were major lung resection and respiratory and/or cardiovascular co-morbidity. Video-assisted surgery showed a protective effect.