Comparison between Laparoscopic surgery vs Open surgery in Patients with interstitial lung disease

Kentaro Hayashi, MD1, Nobuyasu Kano, MD1, Kei Nakashima, MD2, Hiroshi Sugimura, MD3, Hiroshi Kusanagi, MD1. 1Kameda Medical Center Gastroenterological Surgery, 2Kameda Medical Center Respiratory Medicine, 3Kameda Medical Center Thoracic Surgery

Introduction: Patients with interstitial lung disease (ILD) have high incidence of postoperative pulmonary complications after lung resection. But there is little data about these complications in ILD after abdominal surgery. Especially, there is no data of complications in ILD patients after Laparoscopic surgery.

Laparoscopic surgery needs artificial pneumoperitoneum which restricts pulmonary function. This condition may be serious for some ILD patients.

The objective of this study is to examine whether laparoscopic surgery should be used for ILD patients, or not.

Materials and Method: We examined clinical data of patients diagnosed as ILD in Kameda Medical Center, then selected all of the 57 patients who underwent abdominal surgery under general anesthesia during 2005-2015. Twenty-three patients underwent laparoscopic surgery, and open surgery was performed in 34 patients. We collected clinical data of these patients and compared laparoscopic surgery group with open surgery group retrospectively.

Results: In comparison between laparoscopic surgery group (n=23) and open surgery group (n=34), median age (75: 79.5, P<0.05), males (16:22 P=0.78), median operation time (173 min: 143 min, P=0.17), median estimated blood loss (30ml: 265ml, P<0.05), emergency cases (4:14, P=0.08), perioperative complications defined as Clavien-Dindo Classification >=2 (4:10, P=0.36), pulmonary complications (1:5, P=0.39), acute exacerbations of ILD in 30 days (1:3, P=0.64) and postoperative mortality cases (1:3, P=0.64) were found respectively

All of the 4 cases with acute exacerbations of ILD in 30days are emergency operations.

Conclusions: Laparoscopic surgery is not an aggravating factor for ILD in comparison with open surgery. An emergency operation has relatively high risk for acute exacerbations of ILD in both of laparoscopic surgery and open surgery. But as far as abdominal operations are performed electively, ILD patients may not have high risk of acute exacerbations as those who are scheduled to undergo lung operations.

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