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2024 World Conference on Lung Cancer (WCLC) - ePos ...
EP.07A.12 Association Between Preoperative Diaphra ...
EP.07A.12 Association Between Preoperative Diaphragm Thickness and Postoperative Complications in Elderly Patients with Lung Cancer
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This study investigates the correlation between diaphragm thickness (DT) and postoperative complications in elderly patients with non-small cell lung cancer (NSCLC) who underwent pulmonary resection. It centers on sarcopenia, a condition involving the progressive loss of muscle mass and strength, known to amplify the risk of complications in surgical patients. According to the study, DT measurements derived from CT scans can predict such complications within the first 30 days post-surgery, categorized by the Clavien-Dindo classification for Grade 2 complications.<br /><br />Data was gathered from 101 elderly patients, with an average age of 78, undergoing either lobectomy or segmentectomy. The study found that patients with a mean diaphragm thickness (MDT) less than 3.4 mm demonstrated a greater incidence of postoperative complications, such as pleural leakage, pneumonia, and arrhythmia, and poorer overall survival rates compared to those with thicker diaphragms.<br /><br />The research establishes an MDT of 3.4 mm as the critical threshold, with significant implications for both preoperative assessment and postoperative management. Portrayed in both ROC curves and sensitivity-specificity analyses, the MDT serves as a valuable indicator, reaffirmed by univariate and multivariate analyses.<br /><br />While CT images are lauded for their reliability in measuring DT, the study advocates for the utility of diaphragm-focused assessments in identifying high-risk patients, emphasizing the importance of specialized perioperative strategies like respiratory rehabilitation to improving outcomes. This aligns with existing literature linking diminished respiratory muscle strength and sarcopenia with inferior postoperative results and survival rates in lung cancer patients. The findings urge thoracic surgery practices to integrate DT measurements into patient evaluations, fostering better-informed clinical decisions and enhanced postoperative care in at-risk populations.
Asset Subtitle
Shoji Kuriyama
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Speaker
Shoji Kuriyama
Topic
Early-Stage Non-small Cell Lung Cancer
Keywords
diaphragm thickness
postoperative complications
elderly patients
non-small cell lung cancer
sarcopenia
CT scans
Clavien-Dindo classification
lobectomy
segmentectomy
respiratory rehabilitation
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