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人工透析患者に合併した肺癌に対する肺切除術の経験


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Title: 人工透析患者に合併した肺癌に対する肺切除術の経験
Other Titles: Pulmonary Resection for Lung Cancer in a Patient on Maintenance Hemodialysis
Authors: 綾部, 公懿 / 内川, 徹也 / 仲宗根, 朝紀 / 谷口, 英樹 / 川原, 克信 / 富田, 正雄
Authors (alternative): Ayabe, Hiroyoshi / Uchikawa, Tetsuya / Nakasone, Tomonori / Taniguchi, Hideki / Kawahara, Katsunobu / Tomita, Masao
Issue Date: 20-Dec-1989
Publisher: 日本肺癌学会
Citation: 肺癌 = Japanese Journal of Lung Cancer, 29(7), p.805-810; 1989
Abstract: 症例は63才の男性で,57才時より慢性腎不全の診断で人工透析を受けていたが,咳嗽,血疾が出現したので胸部レ線検査を受けたところ左上肺野に異常影を発見され,肺癌と診断された.左肺上葉切除,気管支形成術及び縦隔リンパ節郭清術が施行された.病理診断は中分化扁平上皮癌(T2N2M0StageIIIA)であった.術後の経過は良好で化学療法施行後退院した.慢性腎不全に対し人工透析中に発見された肺癌切除例の経過と術前後の管理を中心に報告した. / A case with lung cancer diagnosed and operated during hemodialysis for chronic renal failure was reported. A 63-year-old man on maintenance hemodialysis was admitted to the hospital because of cough and bloody sputum. A chest X-ray showed a mass shadow on the left upper lung field and sputum cytology revealed malignant cells. Left upper sleeve lobectomy and mediastinal lymph node dissection was carried out without any major complication. Histologically, moderately differentiated squamous cell carcinoma was diagnosed and metastasis was found in subaortic and hilar lymph nodes (T_2N_2M_0 Stage IIIA). The postoperative course was uneventful under careful management for hemodialysis and adjuvant chemotherapy including cisplatin was given. Careful preoperative evaluation of cardiovascular and hematologic disturbances and correction of hyperkalemia and anemia by hemodialysis and blood transfusion are important. Prevention of fluid overload and hyperkalemia by monitoring of ECG and CVP during operation and careful observation of the patients and early hemodialysis within 24 hours after surgery are required to avoid serious postoperative complications. With the above appropriate perioperative management,pulmonary resection for lung cancer can be carried out without major complication for the patients under hemodialysis for chronic renal failure.
Keywords: Lung cancer / Pulmonary resection / Maintenance hemodialysis
URI: http://hdl.handle.net/10069/20241
ISSN: 03869628
Relational Links: http://ci.nii.ac.jp/naid/110003119559/
Rights: 日本肺癌学会 / 本文データは学協会の許諾に基づきCiNiiから複製したものである
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/20241

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