Gastrointestinal complications in lung transplant survivors that require surgical intervention

被引:36
作者
Hoekstra, HJ
Hawkins, K
de Boer, WJ
Rottier, K
van der Bij, W
机构
[1] Univ Groningen Hosp, Dept Surg, NL-9700 RB Groningen, Netherlands
[2] Univ Groningen Hosp, Dept Cardiothorac Surg, NL-9700 RB Groningen, Netherlands
[3] Univ Groningen Hosp, Dept Pulmonol, NL-9700 RB Groningen, Netherlands
关键词
D O I
10.1046/j.1365-2168.2001.01693.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Lung transplantation is widely accepted as a treatment for end-stage lung disease. At present, information regarding the incidence and outcome of acute gastrointestinal complications in lung transplant survivors is limited. Methods: Since 1990, 127 lung transplantations have been performed in 125 patients: 73 males (58 per cent) and 52 females (42 per cent) of median age 43 (range 9-64) years. Patients received a standard induction and maintenance regimen of immunosuppression. Results: At a median follow-up of 2.6 (range 0-8.6) years the overall survival rate was 68 per cent. An acute abdomen requiring surgical intervention was diagnosed in 12 patients (10 per cent). The median time following lung transplantation was 19 (range 3-68) months. Eight cases of bowel perforation, two of appendicitis, one of colitis, one of cholecystitis, and one pneumoperitoneum were encountered. Four Hartmann procedures, two sigmoid resections, one small bowel resection, two appendicectomies, a subtotal colectomy, a cholecystectomy and an exploratory laparotomy were performed with minimal morbidity and no postoperative death. Conclusion: Lung transplant survivors are at increased risk of developing an acute abdomen because of the use of high-dose immunosuppressive agents. Physicians who evaluate lung transplant patients for an acute abdomen should have a low threshold for surgical intervention.
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页码:433 / 438
页数:6
相关论文
共 30 条
[1]
AUGUSTINE SM, 1991, J HEART LUNG TRANSPL, V10, P547
[2]
Colon perforation after lung transplantation [J].
Beaver, TM ;
Fullerton, DA ;
Zamora, MR ;
Badesch, DB ;
Weill, D ;
Brown, JM ;
Campbell, DN ;
Grover, FL .
ANNALS OF THORACIC SURGERY, 1996, 62 (03) :839-843
[3]
OPTIMAL TIMING AND INDICATIONS FOR CHOLECYSTECTOMY IN CARDIAC TRANSPLANT PATIENTS [J].
BEGOS, DG ;
FRANCO, KL ;
BALDWIN, JC ;
LEE, FA ;
REVKIN, JH ;
MODLIN, IM .
WORLD JOURNAL OF SURGERY, 1995, 19 (04) :661-667
[4]
ACUTE PERFORATION OF COLONIC DIVERTICULA ASSOCIATED WITH PROLONGED ADRENOCORTICOSTEROID THERAPY [J].
CANTER, JW ;
SHORB, PE .
AMERICAN JOURNAL OF SURGERY, 1971, 121 (01) :46-&
[5]
CATES J, 1991, AM J GASTROENTEROL, V86, P412
[6]
Fenton JJ, 1997, J HEART LUNG TRANSPL, V16, P681
[7]
Cyclosporine induces cancer progression by a cell-autonomous mechanism [J].
Hojo, M ;
Morimoto, T ;
Maluccio, M ;
Asano, T ;
Morimoto, K ;
Lagman, M ;
Shimbo, T ;
Suthanthiran, M .
NATURE, 1999, 397 (6719) :530-534
[8]
Hosenpud JD, 1998, J HEART LUNG TRANSPL, V17, P656
[9]
GASTROINTESTINAL COMPLICATIONS AFTER CARDIAC TRANSPLANTATION - POTENTIAL BENEFIT OF EARLY DIAGNOSES AND PROMPT SURGICAL INTERVENTION [J].
KIRKLIN, JK ;
HOLM, A ;
ALDRETE, JS ;
WHITE, C ;
BOURGE, RC .
ANNALS OF SURGERY, 1990, 211 (05) :538-542
[10]
LYMPHOPROLIFERATIVE DISORDERS AFTER ORGAN-TRANSPLANTATION - A REPORT OF 24 CASES OBSERVED IN A SINGLE-CENTER [J].
LEBLOND, V ;
SUTTON, L ;
DORENT, R ;
DAVI, F ;
BITKER, MO ;
GABARRE, J ;
CHARLOTTE, F ;
GHOUSSOUB, JJ ;
FOURCADE, C ;
FISCHER, A ;
GANDJBAKHCH, I ;
BINET, JL ;
RAPHAEL, M .
JOURNAL OF CLINICAL ONCOLOGY, 1995, 13 (04) :961-968