Rib Osteosynthesis for Sub-Acute Management of a Flail Chest in a Tertiary Centre in a Low-Middle Income Country of Sub-Saharan Africa: Case Report at Douala Laquintinie Hospital

Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.

In-Hospital Outcomes in Minimally Invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel® program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.

Isolated Tricuspid Valve Repair and Right Atrial Plication Performed Using a Beating-Heart Technique for Atrial Functional Tricuspid Valve Regurgitation

Background: Isolated tricuspid valve disease remains a controversial indication for surgical intervention. Many patients referred for surgery already have a poor clinical condition and an advanced New York Heart Association functional class. There is no consensus on the optimal surgical technique for this condition, including on whether to perform the procedure on a beating or an arrested heart and whether to perform valve repair or replacement. Methods: We analyzed four case series between 2015 and 2022 in which patients with secondary tricuspid regurgitation (TR) underwent valve repair on a beating heart and right atrial plication for a dilated right atrium. The TRI-SCORE was calculated for each patient. Results: All patients experienced a favorable postoperative course with significant improvements in heart failure symptoms. TR was markedly reduced;however, in one patient with concomitant mitral regurgitation (MR) and a high TRI-SCORE, MR worsened postoperatively. This patient later died from unknown causes due to multiple comorbidities in the late phase. Conclusions: Tricuspid valve repair on a beating heart was effective for improving the cardiac function, and the TRI-SCORE proved useful as a preoperative risk assessment tool. The underlying mechanism by which TR exacerbates MR requires further investigation.

Impact and Management under Extracorporeal Circulation of a Patient with Renal Insufficiency on Dialysis with a High-Flow Arteriovenous Fistula in the Cardiac Surgery Department of the Angers Teaching Hospital about a Case and Review of the Literature

Arteriovenous fistulas have a substantial impact on systemic hemodynamics, however their effect on extracorporeal circulation is not well understood. We report our clinical observation on the management under extracorporeal circulation of a patient with renal insufficiency with a high-flow arteriovenous fistula. This is a 59-year-old man who was referred to us for surgical treatment of ischemic coronary artery disease in a context of anuric chronic renal failure. Hypothermia at 32°C is started from the start in CEC due to hyperflow at the level of the arteriovenous fistula. We performed two coronary artery bypasses of the marginal and IVA via the two internal thoracic arteries. The patient is hemofiltered in order to avoid hyperkalaemia and possibly avoid fluid overload related to filling per CEC. The clamping time was 71 minutes and the SCC lasted 141 minutes. There was no homologous transfusion in the operating room. It turns out that the input/output balance is zero at the end of the CEC. The postoperative course was simple.

Esophageal Replacements for Caustic Esophageal Stenosis in Adults about 9 Cases in Ouagadougou

Objective: To report our experience of the esophageal plasty for caustic stenosis of the esophagus. Methods: Retrospective study of caustic stenosis of the esophagus in patients aged over 15 years, operated in Ouagadougou from 2008 to 2016. Nine patients were operated. Patients ranged in age from 25 to 53 years. Caustic ingestion was voluntary in 6 cases. Psychiatric disorders were confirmed in one case. The type of surgery and the postoperative evolution were analyzed. Results: In 6 patients the plasty was preceded by a gastrostomy or a feeding jejunostomy. The transplant, always placed in retro sternal position, was colic in 8 cases and gastric in one case. The evolution was marked by the occurrence of a cervical fistula in 5 cases, postoperative peritonitis in 2 cases, parietal suppuration in 2 cases and pneumothorax in 3 cases. One case of death was noted. After a follow-up of 6 months to 9 years, we noted a case of dysphagia. Conclusion: Esophageal plasty is a saving gesture that restores normal nutrition to the patient. It deserves to be promoted.

Myocardial Protection with Beta Blocker Treatment in Infants with Heart Failure Due to Congenital Heart Defects and Duchenne Muscular Dystrophy

Our first intention to treat infants’ heart failure with beta blockers was to improve the clinical condition as shown in our prospective randomized trial. We only use non-selective beta blockers in these infants, carvedilol in those with left ventricular dysfunction and propranolol in those with congenital heart disease without ventricular dysfunction. Despite a significant improvement of Ross’s heart failure score, we could not convince most colleagues within the last 25 years if the concept of neurohumoral activation in heart failure is not well-established pediatric cardiology. Recently, Honghai Liu et al. published that cardiomyocyte cytokinesis failure was increased in congenital heart disease. Inactivation of the beta adreno receptors genes and administration of the beta-blocker propranolol increased cardiomyocyte division in neonatal mice, which increased the number of cardiomyocytes (endowment) and conferred benefit after myocardial infarction in adults. We currently realize that propranolol in infants with congenital heart disease not only decrease highly elevated NT-Pro-BNP values but also decrease cardiac troponin T values that may indicate myocardial injury due to neurohumoral activation. We reproduce this observation, primarily seen in infants with congenital heart disease, in an infant with Duchenne muscular dystrophy. These observations were in good accordance with current data from H. Liu et al., who showed that treatment with non-selective beta blockers early after birth might rescue cytokinesis defects and prevent heart dysfunction in adulthood in a mouse model.

Oesophagocardiomyotomy for Achalasia Cardia via Thoracotomy in a Teaching Hospital in Ghana: A 5-Year Retrospective Review

Achalasia cardia is a primary oesophageal motility disorder of unknown aetiology characterized manometrically by insufficient relaxation of the lower oesophageal sphincter (LES) and loss of oesophageal peristalsis;radiographically by aperistalsis, oesophageal dilation with minimal LES opening, bird-beak appearance, poor emptying of barium;and endoscopically by dilated oesophagus with retained saliva, liquid and undigested food particles in the absence of mucosal stricturing or tumour. Achalasia cardia patients usually present with difficulty in swallowing both solids and liquids and this may be associated with regurgitation, heartburn and chest pains. Treatment options include medical or pharmacologic therapy, botulinum toxin injection, pneumatic dilation and oesophagocardiomyotomy or the Heller myotomy with or without antireflux procedure and recently the POEM (Perioral oesophageal myotomy). Herein, we present our experience with four cases managed surgically via thoracotomy without antireflux surgery over a 5-year period, from January 2015 to June 2019 at the Komfo Anokye Teaching Hospital, the second largest teaching hospital in Ghana.

Successful Use of Intercostal Muscle Flap in Cavitary Lung Lesions

Background: Lung cavities sometimes result from a number of pathological processes including suppurative necrosis, caseous necrosis, ischemic necrosis and cystic dilatation of lung structures. The aim of this study is to evaluate the use of intercostals muscle flap as a successful method to fill the lung cavity for reduction of symptoms and treatment of patients presented with symptomatic pulmonary cavity and to avoid the risk of pulmonary resection. Methods: This is a prospective study conducted between 2009 to 2012, in department of cardiothoracic surgery, Zagazig University Hospital. The study included 32 patients suffering from cavitary lung lesions divided into two groups, group (A): 14 patients treated by using intercostal muscle flap to fill the defect after Cavernostomy without lung resection;and group (B): 18 patients treated by traditional methods by lung resection. Patients with high risk of lung resection, suspicion of dense adhesion, symptomatic chronic lung abscess and patients with bad pulmonary function tests were included in group (A). Results: 20 patients were male and 12 were females in both groups, the large numbers of cases were lung abscess in group A (4 cases 28.5%) followed by Aspergilloma and TB cavity (3 cases 21.4%). Hemoptysis, persistent cough and expectoration were the main presentation of our patients. Poor pulmonary function was significant finding in group A (7 cases 50%). Complications reported in our study were bleeding, recurrent symptoms and one case mortality in group B after Pneuomenectomy. Conclusion: Using the intercostal muscle flap implanted inside the lung cavity after cavernostomy is a successful alternative curative method especially in cases with high risk of lung resection.

The Selective Conservative Management of Small Traumatic Pneumothorax Following Stab Injuries of the Chest in Emergency Department Patients

Background: Chest trauma is a catastrophic event that affects large number of population and leads to morbidity, disability and mortality. The definition of an occult pneumothorax is uncontested. It is a pneumothorax that was not suspected on the basis of clinical examination or plain radiography, but was ultimately detected with CT and usually treated conservatively. We evaluated the success of selective conservative management of small pneumothorax following stab chest injuries, in Emergency Department patients. Methods: This prospective study was conducted on 30 adult patients admitted to the emergency department with small traumatic pneumothorax following stab injury. All enrolled patients (n = 30) were assessed for the following, demographic data, laboratory investigations, chest x-ray and CT scan. The outcomes measured were discharge safely after successful conservative management, Initial conservative then invasive measurement. Results: There was a statistically significant difference between conservative and non-conservative types of management in the incidence of complications after 1 week follow up (p = 0.001). Conclusion: The majority of asymptomatic small pneumothorax patients following a stab injury can be managed conservatively. Haphazard chest tube insertion and aging may lead to complications in such patients.

Unusual Case of Pneumothorax Caused by Costal Osteochondroma

Osteochondroma is the most common benign cartilage tumor. Although, most lesions are asymptomatic, life-threatening conditions caused osteochondromas have been reported in the literature such pneumothorax, hemothorax, diaphragmatic rupture, and lung injury. We report a case of a thirty year old male who presented with shortness of breath and was found to have a pneumothorax on chest X-ray. Subsequent Computed Tomography of the chest revealed a 1.3 cm growth on the posterior portion of the fourth right rib protruding into the right middle lobe. The patient underwent thoracoscopic resection of the lesion along with a wedge resection of the right middle lobe. The rib was reconstructed using a metal plate. He remains asymptomatic without recurrence on a one year follow up.

Acute Type A Aortic Dissection—Replacement of Ascending Aorta, Aortic Arch and Antegrade Stenting of the Descending Thoracic Aorta Using the Thoraflex™Hybrid Plexus Device (Terumo Aortic)—“Frozen Elephant Trunk”: The Plymouth Way!

Objectives: To describe our technique for the implantation of the Thoraflex Hybrid prosthesis for replacement of the aortic arch in a safe and reproducible way. Materials: Thoraflex™ Hybrid Plexus Device (Terumo Aortic). Design: Drawing on our own experience over the past 4 years in the management of acute type A aortic dissection, we have distilled the essentials of our “Frozen Elephant Trunk” technique which have led us through our own learning curve to the improved management of this taxing condition. Method/ Results: Small extension of the median sternotomy incision along the medial border of sternocleidomastoid muscle. End to side graft anastomosis near the origin of the left subclavian artery during cooling on bypass towards 20 degrees. Attention to cardiac protection and maintenance of cerebral perfusion during the shortened corporeal arrest period. Excellent results in 24 consecutive AAAD patients with just one hospital mortality. Conclusions: We believe we are entering a new phase in the treatment of AAAD, facilitated by the availability of a hybrid prosthesis which combines expanding stent technology with familiar surgical graft material. Our particular management of the left subclavian artery and of the cerebral circulation during implantation has contributed to an expeditious and reproducible method of treating dissection within the arch of the aorta and beyond.

Predictors of Malignant Pathology and the Role of Trans-Thoracic Needle Biopsy in Management of Solitary Fibrous Tumors of the Pleura: A 30-Year Review of a Tertiary Care Center Patient Cohort

Background: Solitary fibrous tumors of the pleura (SFTP) are rare neoplasms with unpredictable behavior. Lack of unifying criteria for benign or malignant SFTP has resulted in reports of SFTP exhibiting malignant behavior years after complete surgical resection (despite benign initial diagnosis). Additionally, the role of trans-thoracic needle biopsy in initial management of SFTP is unclear. Understanding predictors of malignancy identifies patients at unacceptably high risk for non-surgical primary therapy, and for recurrence despite complete surgical resection. Objectives: The primary objectives were to identify clinicopathological predictors of malignancy & recurrence in SFTP. The secondary aim was to determine the role of trans-thoracic needle biopsy in the management decision algorithm of SFTP. Methods: Retrospective chart review was conducted (Jan. 1983-Dec. 2013) at the Ottawa Hospital for pathologically confirmed SFTP. Data were collected on biopsy-related, clinical, histopathological & immunohistochemistry (IHC) variables. Appropriate tests of statistical inference were conducted for all variables. Results: Pathologically confirmed SFTP was identified in 26 cases. Transthoracic needle biopsy was conducted in 22 (84.6%);with 16 (72.7%) biopsies diagnostic of SFTP with IHC;3 (13.6%) being malignant. Primary management was surveillance in 3 and complete surgical resection in 23. Surgical pathology reported 15 (65.2%) benign and 8 (34.8%) malignant cases. Local recurrence occurred in 3 and distant recurrence in 1. Initial pathology was benign in 3 (75%) with recurrence. Clinicopathologic variables analyzed did not predict recurrent disease. IHC features did not differ between malignant & benign pathology significantly. Predictors of malignant pathology included: infiltrative cellular pattern (p = 0.042), nuclear crowding (p = 0.006), tumour necrosis (p 4 mitoses/ 10 high power field (p Conclusion: Because numerous variables analyzed did not predict recurrent disease, long-term follow-up is warranted regardless of benign or malignant initial histology. Histologic not IHC features predicted malignant pathology. Trans-thoracic needle biopsy did identify malignant SFTP;however its main use should be to differentiate SFTP from other pleural neoplasms using IHC.

Diaphragmatic Plication: Retrospective Study with 54 Patients

Objective: This study seeks to evaluate the results of surgery performed according to the etiological causes of diaphragmatic eventration or paralysis. Method: Files of 54 patients (35 males, 19 females;mean age: 39.1 ± 3.01 years) who had undergone diaphragm plication between January 2005 and June 2011 in two clinics located in Istanbul were studied in terms of pulmonary spirometry, applied surgical procedure, duration of hospitalization, morbidity, and mortality. Results: In diaphragm plications, observed etiologies were isolated diaphragmatic eventration without phrenic nerve injury (Group 1) in 20 (37%) patients due to blunt thoracic trauma;Group 2 (thymoma in 19 (35.2%) patients;lung cancer in 7 (12.9%) patients;mediastinal tumor in 3 (5.6%) patients) and congenital heart surgery (Group 3) in 5 (9.3%) patients. The mean time to plication was 7.4 months in Group 1. The mean duration of hospitalization was 4 days in Group 1, 6.2 days in Group 2, 11.8 days in Group 3. Mean forced vital capacity, forced expiratory volume at 1 second improved by 17%, 20.3%, respectively (p In Group 1, mean dyspnea-related hospital admission before plication was 2.4 times. At the end of 6 months after plication mean dyspnea-related hospital admission was 0 time. All of them returned to daily activities or their job within 6 months in Group 1. Postoperative mortality was observed in 2 (3.7%) patients in Group 3 while the overall complication rates were 24%. The morbidity rates were 8%, 27.5%, 60%, respectively;and the mortality rates were 0%, 0%, 40%, respectively. Conclusion: As a result, it could be suggested that early and timely performed plications for diaphragmatic eventration improves functional status and assesses a shorter lenght of stay. On the other hand,simultaneously performed plications in intraoperative phrenic nerve resections can be performed with acceptable morbidity and no mortality. In diaphragmatic paralysis due to congenital heart surgery, morbidity and mortality rate is still high.

Mitral Valve Repair for Mitral Valve Regurgitation with Papillary Muscle Displacement and Posterior Leaflet Prolapse

A case of abnormal chordae of the mitral valve (MV) associated with systolic anterior motion (SAM) is not commonly encountered in clinical practice. Here we report MV repair via the edge-to-edge technique in a 56-year-old male with MV regurgitation associated with papillary muscle displacement and posterior leaflet prolapse. Echocardiography revealed obstruction of the left ventricular outflow tract caused by SAM because of papillary muscle displacement and mitral regurgitation associated with posterior leaflet prolapse due to chordae rupture. MV repair was successfully performed by reconstruction with an Alfieri stitch. The outcome of this case demonstrated that this surgical technique is preferable for MV abnormalities with no complex malformations.

A Resection of the Giant First Left Rib Tumor and Chest Wall Reconstruction by Transmanubrial Osteomuscular Sparing Approach

A 64-year-old female had noticed an 11 × 6 cm mass growing on her left first rib. We performed a resection of the first and second ribs and a reconstruction of the chest wall. A thoracotomy was performed at the anterolateral second intercostal space. The second rib cartilage was divided at the left parasternum. Based on a transmanubrial osteomuscular sparing approach, the left-upper part of the sternum and the first rib cartilage were both cut at the left clavicular-sternum joint. The posterior parts of the two ribs involving the tumor were resected at the transverse process of the vertebral bone by tearing off the anterior, middle, and posterior scalene muscles, subclavicular artery and vein. The defect size of the thorax was 15 × 9 cm, which was reconstructed by covering with a polytetrafluoroethylene dual mesh (Dual mesh, Gore tex, 2 mm). The major pectoral muscle flap was used to cover the mesh. The postoperative pathological examination diagnosed a poorly differentiated fibrosarcoma. Eventually, she had palliative therapy for the postoperative metastatic chest wall. She died 14 months after the operation.

Implications of the VerifyNow P2Y12 Assay on Patient Outcomes

Background: The platelet inhibitory response of clopidogrel is substantially variable among patients, and numerous studies have shown that post-percutaneous intervention, patients with high on-treatment platelet reactivity have an increase in risk of major adverse cardiovascular events. No published studies to date have utilized platelet function monitoring assays prior to coronary artery bypass graft (CABG) surgery, but determination of patients’ antiplatelet effects prior to surgery may decrease time to surgery and length of hospital stay. The purpose of the study was to evaluate the clinical outcomes of non-elective CABG patients analyzed by the VerifyNow P2Y12 platelet-function monitoring assay prior to surgery compared to a similar set of patients not analyzed by the VerifyNow P2Y12 assay. Methods: This was a retrospective, single center, cohort study. The primary endpoints of this study were time to surgery and length of hospital stay. Results: From March 2013 to July 2013, 60 patient charts were reviewed and included in this study. 49 patients were analyzed by the VerfiyNow P2Y12 assay, and 16 of these patients underwent non-elective CABG surgery. Eleven patients underwent non-elective CABG surgery and were not analyzed by the VerifyNow P2Y12 assay. There was no difference between groups regarding time to surgery (p = 0.75) or length of stay (p = 0.42). Based on the assay’s P2Y12 reaction unit results, 69% of VerifyNow P2Y12 patients went to surgery sooner than the institution’s recommendations which generated more bleeding events, half of which were considered major bleeds. Conclusions: Utilization of the VerifyNow P2Y12 assay prior to non-elective CABG surgery does not shorten time to surgery or overall length of hospital stay. However, insufficient P2Y12 reaction units prior to surgery may lead to more bleeding events, thus the application of platelet function monitoring assays prior to procedures may be beneficial as a bleeding risk-assessment tool.

Biomarkers and Echocardiography in the Postoperative Course of Pulmonary Resection Surgery

Background: The existence of different degrees of inflammatory reaction and right ventricular dysfunction after pulmonary resection is well known, though its detection and clinical relevance have not been sufficiently evaluated. The introduction of new biomarkers, particularly brain natriuretic peptide (BNP) and its prohormone (proBNP), together with dynamic imaging techniques such as echocardiography, could prove useful in assessing such response. The aim of this study is to describe the kinetic curve of these biomarkers during uncomplicated pulmonary resection surgery. Furthemore we have studied the right ventricular function by echocardiography in these patients Methods: Demographic data, antecedents and certain perioperative parameters, as well as plasma proBNP, troponin T and C-reactive protein (CRP) levels, were recorded in 38 patients who underwent pneumonectomy (n= 13 ) and lobectomy (n=25), before and 24, 48 and 72 hours after the operation. A transthoracic echocardiogram was carried out preoperatively and 72 hours after surgery. Results: ProBNP showed a significant increase 24 hours after surgery, with a maximum peak after 72 hours (p<0.001). CRP likewise increased after 24 hours, with an inflammatory peak after 48 hours (p<0.001). The magnitude of the increase in proBNP and CRP was independent of the extent of resection (pneumonectomy versus lobectomy). Echocardiography showed a slight yet statistically significant decrease in right ventricular function (determined by tricuspid annular plane systolic excursion, TAPSE) in the pneumonectomy subgroup (p=0.01). Conclusion: The plasma proBNP elevation curve allows simple evaluation of the degree and time course of right ventricular dysfunction in the immediate postoperative period of uncomplicated pulmonary resection surgery. In stable patients, magnitude of proBNP elevation has no clinical repercussions, while slight echocardiographic changes are detectable only in pneumonectomized patients. Further studies are needed to evaluate the usefulness of abnormal proBNP elevations in predicting cardiorespiratory complications at patients bedside during the immediate postoperative period.

Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options

Background: Superior sinus venosus atrial septal defect (SV-ASD) is an interatrial defect with partial anomalous pulmonary venous connection (PAPVC) draining into the right atrium. The principle for SV-ASD surgical repair involves redirecting the pulmonary venous blood back to the left atrium and closure of the atrial septal defect without compromising the adjoining structures. Methods: We reviewed English literature relating to this topic via a MEDLINE and Google scholar search using the following terms: surgery for sinus venosus atrial septal defect (SV-ASD), surgery for partial anomalous pulmonary venous connection (PAPVC) and complications of the surgery. Results: A total of 910 consecutive cohort patients with different surgical options between 1984 to 2012 were analyzed. The breakdown showed that 291(32.0%) had single-patch, 275(30.2%) had Warden’s procedure, 185(20.3%) had a double-patch and 159(17.5%) had use of autologous right atrial appendage for the anastomosis. The total follow-up was between 0.008-30 years. Sinus node dysfunction (SND) was the commonest complication occurring mostly in patients who had double-patch technique 16(8.6%) followed by 15(5.5%) patients with single-patch technique, 7(4.4%) patients in whom right atrial appendage was used and 5(1.8%) patients with Warden’s procedure. Venous obstruction occurred in 22(7.7%) patients with SP, 13(5.1%) patients with Warden’s Procedure and 5(2.7%) patients with double-patch. Conclusion: The two major complications, SND and venous obstruction, assumed a see-saw approach as surgical maneuvers avoiding venous obstruction encouraged SND and vice versa. However, adopting surgical options which avoided incision across the Cavoatrial junction attenuated all the complications.

Anomalous Left Coronary Artery from Pulmonary Artery with Good Ventricular Function in an Adult. A Rare Scenario

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) with preserved ventricular function is a rare congenital coronary artery anomaly when diagnosed in an adult patient and remains an important cause of sudden cardiac death. We report a 42-year-old patient with ALCAPA managed with intrapulmonary interruption of the left main coronary artery (LMCA) ostea and grafting of the LMCA with left internal mammary artery so as to restore antegrade coronary flow. This restores a dual-coronary-artery system and also allows antegrade blood flow as in a normal coronary artery to a large area of viable myocardium. This strategy is simple to accomplish and is more physiological in an anteriorly placed and dilated LMCA as seen in our case.

Preoperative Serum Krebs Von Den Lungen-6 and Surfactant Protein-D Levels in Non-Small Cell Lung Cancer Patients with Interstitial Pneumonia

We retrospectively analyzed the prognostic significance of preoperative serum Krebs von den Lungen-6 (KL-6) surfactant protein-D (SP-D) levels in non-small cell lung cancer (NSCLC) patients with interstitial pneumonia (IP). We enrolled 41 NSCLC patients with IP who have undergone curative surgery. Prognostic significance of serum KL-6 and SP-D levels was examined. We found a significant relationship between serum KL-6 and SP-D levels in NSCLC patients with IP. However, the 5-year survival of patients with high serum KL-6 level was poor, whereas serum SP-D level was not related to patients’ survival. Univariate analysis revealed that there was a trend towards an association between serum KL-6 level and patients’ prognosis but this did not reach statistical significance. This might be due to small number of study patients. In conclusion, there is a possibility that serum KL-6 level is a prognostic marker regardless of the presence of IP.