Abstract
To treat lung cancer in patients with idiopathic interstitial pneumonia (IIP), special consideration is required to avoid the occurrence of postoperative exacerbation of IIP. We investigated the clinicopathological features and problems of intraoperative and postoperative management. Eight patients with primary lung cancer complicated with idiopathic interstitial pneumonia underwent surgical resection. Seven cases were males and one case was female. Ages ranged from 63 to 77 years. First case died due to acute exacerbation of IIP on the 39th postsurgery day. After the second case, we tried to keep the PaO2 about 80100 mmHg during or after surgery, and 5 cases were alleviated with low-dose steroid during or after surgery, with these cases not developing exacerbation of IIP. After discharge from the hospital, 3 cases developed acute exacerbation of IIP within two months, with these cases finally dying of respiratory failure within 6 months postoperatively. Recently 3 cases administered oral erythromycin after the operation, did not develop exacerbation after discharge from the hospital.
From these results, it was suggested that low-dose O2 and steroid administration during or after surgery for 3 days, erythromycin before the operation and continued after the surgery were very effective to avoid postoperative exacerbation of IIP.
