Lung Cancer Surgery for Patients on Hemodialysis

Andronic Constantin^*
*Correspondence: Andronic Constantin, Department of Surgery, University of Medicine and Pharmacy, Iasi - 700111, Romania, Email:

Keywords

Dialysis • Renal dialysis • Pulmonary

Introduction

Age, increased usage of in cancer patients, the general number of long-term dialysis patients, and improvements in tumour screening are all contributing factors that are driving up the incidence of procedures for malignant tumours in haemodialysis patients. However, pulmonary resection in patients is associated with a high prevalence of postoperative complications, necessitating careful perioperative management. In cases of pulmonary resection for lung cancer in HD patients at our hospital, we looked backward at clinical features, issues with perioperative care, and prognosis. The National Kidney Foundation in the USA coined the term "chronic kidney disease". It encompasses all forms of chronic kidney damage or malfunction, independent of the underlying condition. A glomerular filtration rate of symptoms that suggest renal impairment for more than three months are considered signs of chronic kidney disease According to several researches, people with have a higher frequency of malignant tumours. Additionally, comorbidity is linked to a rise in surgical complications, a higher surgical mortality rate, and a lower overall survival in a number of malignancies.

Discussion

There is debate regarding whether impairs lung cancer patients' ability to survive. Based on information from a national database, there have been a few reports on patients who underwent medical therapy for lung cancer. To our knowledge, however, there haven't been any reports on the results of lung cancer patients with who only underwent surgery. Clarification of the effects of on surgical patients is required because it is unknown how the disease affects the viability of surgery. Following surgery, surgical problems were identified from patient medical records and classified based on the Clavien-Dindo classification, which is divided into surgical complications graded I through. If a patient experienced multiple complications, the grade with the highest level of severity was noted. Severe complications were defined as those of Grade a or above.

Cancer screening is only effective when it improves survival without coming at a significant financial expense. Since the expected remaining lifespan of the majority of dialysis patients is shorter than the time lived to develop malignancy, cancer screening in dialysis patients as applied to the general population is ineffective from the perspective of both cost and survival benefit. However, certain cancers, such as human papillomavirus-associated cervical and tongue cancer and urologic malignancies, are more common among dialysis patients. Therefore, it is essential to deliver cancer screening to dialysis patients on an individual, patient-focused basis.

Following surgery, measures of carcinoembryonic antigens in serum were typically taken every 3 to 6 months based on the results of a chest X-ray, a physical exam, and blood chemistry results. In order to monitor for lung cancer recurrence, contrast-enhanced chest computed tomography contrastenhanced brain or magnetic resonance imaging, and bone scintigraphy were routinely carried out annually during the follow-up period. The period of time from the date of pulmonary resection until the first recurrence or death from any cause is known as the disease-free survival. The primary outcome was overall survival, which was calculated as the amount of time between the date of lung resection and death or the last follow-up for patients who survived [1-3].

The impact of on lung cancer survival is yet unclear. Few studies have examined lung cancer outcomes in people with and it is debatable whether affects lung cancer prognosis. According to Patel et al. in a retrospective investigation of lung cancer patients with had no effect on the clinical course or survival when compared to On the other hand, several scientists asserted that had a detrimental effect on the prognosis of lung cancer?

If less invasive procedures like lung resection and lymph node dissection, which are performed on patients because of their worse clinical features, have any effect on the oncological outcome. Our research indicates that our treatment method is reasonable and that lymph node dissection may be reduced in the present lung cancer surgical strategy because the DFS did not significantly differ between the two groups. Recent research has shown that when it comes to the postoperative prognosis for lung cancer surgery, selective lymph node dissection is not inferior to traditional systematic lymph node dissection additionally; the two groups' recurrence pattern in the current investigation was comparable. Therefore, thoracic surgeons should use an intraoperative frozen section to carefully examine the level of lymph node dissection [4,5].

Conclusion

There are a few study limitations that should be mentioned. First, the power of our statistical findings was constrained by the limited sample size we used and the fact that all of our data had to come from a single institution. Second, due to the lengthy nature of this investigation, positron emission tomography was introduced, changing the diagnostic modalities. Therefore, changes in radiologic examination methods might have had an impact on the patient selection. Third, the preoperative creatinine level was used to classify individuals into phases without taking chronicity into account. The retrospective design also inevitably creates selection bias. Further studies are needed to achieve a more detailed conclusion. Major pulmonary resection frequently comes with pulmonary edoema and injury. Patients receiving hemodialysis find it extremely difficult to maintain fluid balance, making them more susceptible to pulmonary edoema. Hypoxemia and pneumonia can also be brought on by pulmonary edoema. One instance of pulmonary edoema and hospital-acquired pneumonia occurred in the current investigation. The patient was successfully treated with CRRT and intravenous antibiotics despite needing acute care and a lengthy hospital stay.

Acknowledgement

None.

Conflict of Interest

There are no conflicts of interest by author.

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