Early Detection of the Acute Exacerbation of Interstitial Pneumonia after the Surgical Resection of Lung Cancer by Planned Chest Computed Tomography
Acute exacerbation (AE) of idiopathic interstitial pneumonia (IIP) is a near-fatal condition with especially high risk following lung surgery. We conducted a nationwide survey concerning prophylactic therapy to prevent possible AE following lung surgery in Japan. We sent a questionnaire concerning prophylactic therapy immediately before and after lung surgery to a total of 701 institutions, including specific questions about anesthesia. Some prophylactic medication was applied in 128 institutions (prophylactic group : P group). In contrast, no prophylactic therapy was utilized in the remaining 92 institutions (non-prophylactic group : N group). In 1 year, 744 operations were performed for lung cancer associated with IIP. In the P group, the prevalence of AE following surgery was 7.8%, and the mortality rate was 48.4%. In the N group, the prevalence was 9.6%, and the mortality rate was 32.2%. In 204 departments (92.7%), certain specific settings for ventilation or surgery were applied. In conclusion, it is necessary to further evaluate the feasibility of such prophylactic therapy, and standard guidelines should be established.