Experience with fatal interstitial pneumonia after operation for lung cancer

Background. The number of patients with lung cancer is increasing. This stu dy was undertaken to realize the probability, fate and management of acute fatal postoperative complications, Since interstitial pneumonia was one of the most fatal postoperative complications, to know its incidence and fate is very important. Methods. A total of 2667 patients who underwent thoracotomy caused by malig nant tumors during the past 17 years were reviewed and studied. We performe d investigations on medical records, chest X-rays, whole-body CT films, ope rative records and pathological specimens for all inpatients Results. Nineteen patients died in hospital 30 days after thoracotomy (oper ative death). Nine patients died in hospital more than 31 days after thorac otomy (hospital death). Eight cases out of 28 patients (operative and hospi tal deaths) developed and finally died by interstitial pneumonia, Each case was treated with steroids, neutrophil-elastase inhibitor, and/or immunosup pressive agents. These patients could not be selected by any preoperative l aboratory examination, such as preoperative pulmonary function tests, serum biochemistry tests, and chest X-ray or CT films, Interstitial pneumonia as a complication of postoperative stage, was fatal and once developed, it wa s very difficult to save their lives. Conclusions. Since we reported the cases who died from acute postoperative complications, especially interstitial pneumonia, we could not present effe ctive management. However, in this report, several therapeutic trials that may solve the problems of acute postoperative interstitial pneumonia were p roposed.