RESUMO
Background The prognostic nutritional index (PNI) is a valuable marker for evaluating the nutritional status associated with postoperative complications and the prognosis of patients with cancer. However, the role and clinical value of PNI in infection after lung cancer surgery remains unclear. This study examined the association between PNI and infection after lobectomy for lung cancer, focusing on the predictive value of PNI. Methods We conducted this retrospective cohort study on 139 patients with non-small cell lung cancer (NSCLC) who underwent surgery between September 2013 and December 2018. Two groups were composed according to their PNI values (≥ 50 or <50 ), and the relationship was assessed with infection after lobectomy. Results Only PNI values, atelectasis, and prolonged air leaks were significantly associated with the development of infection. The median preoperative PNI was 52.97±5.69. Postoperative infection was seen in patients (15.5%) with PNI≥ 50 and 38.1% in patients with PNI <50. The mean PNI in patients with postoperative infection, empyema, and prolonged air leakage was lower than in patients without these conditions. Conclusions Malnutrition is commonly seen in patients with malignancy. The overall malnutrition rate is 45% in lung cancer patients. Patients with metastatic diseases are malnourished in a 73% ratio compared to 5% for localized diseases. Furthermore, malnutrition increases the tendency of postoperative infection and reduces wound healing. We aim to determine whether PNI can be a predictive index marker for postoperative infection in patients with NSCLC who underwent lobectomy. Postoperative infection was seen in 15.5% of patients with PNI>50 and 38.1% in patients with PNI <50.
RESUMO
BACKGROUND: In this study, we aimed to evaluate the success of surgery and a complete resection for bronchiectasis treatment and to present our 23 years of surgical experience. METHODS: Between January 1991 and December 2013, a total of 1,357 patients (667 males, 690 females; mean age 30.5±14.3 years; range, 3 to 73 years) with the diagnosis of bronchiectasis who underwent pulmonary resection in our clinic were retrospectively analyzed. Demographic and clinical characteristics of the patients, etiologies, symptoms, localizations, surgical procedures, and long-term follow-up results were evaluated. RESULTS: There were 1,394 surgeries, as 37 (2.7%) patients had bilateral disease. The surgical procedures included lobectomy (n=702, 50.3%), pneumonectomy (n=183, 13.1%), segmental resections (n=114, 8.2%), bilobectomy (n=83, 6.0%), and lobectomy + segmentectomy (n=312, 22.4%). During the postoperative period, 1,269 (93.5%) patients were followed at a mean duration of 51.6 (range, 1 to 120) months. After surgery, 774 (61%) patients were asymptomatic, 456 (35.9%) showed an improvement, and 39 (3.1%) had no response or deterioration. CONCLUSION: The surgical treatment plays an important role in the clinical and symptomatic improvement of patients with bronchiectasis. Surgery reduces the morbidity and mortality rates with careful preoperative preparation and appropriately selected cases.
