Park Seong Yong, Park In-Kyu, Hwang Yoohwa, Byun Chun Sung, Bae Mi-Kyung, Lee Chang-Young
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Korea.
Korean J Thorac Cardiovasc Surg. 2011 Jun;44(3):229-35. doi: 10.5090/kjtcs.2011.44.3.229. Epub 2011 Jun 11.
Following major lung resection, patients have routinely been monitored in the intensive care unit (ICU). Recently, however, patients are increasingly being placed in a general thoracic ward (GTW). We investigated the safety and efficacy of the GTW care after lobectomy for lung cancer.
316 patients who had undergone lobectomy for lung cancer were reviewed. These patients were divided into two groups: 275 patients were cared for in the ICU while 41 patients were care for in the GTW immediately post-operation. After propensity score matching, postoperative complications and hospital costs were analyzed. Risk factors for early complications were analyzed with the whole cohort.
Early complications (until the end of the first postoperative day) occurred in 11 (3.5%) patients. Late complications occurred in 42 patients (13.3%). After propensity score matching, the incidence of early complications, late complications, and mortality were not different between the two groups. The mean expense was higher in the ICU group. Risk factors for early complications were cardiac comorbidities and low expected forced expiratory volume in one second. The location of postoperative care had no influence on outcome.
Immediate postoperative care after lobectomy for lung cancer in a GTW was safe and cost-effective without compromising outcomes in low-risk patients.
在进行肺叶切除术后,患者通常会在重症监护病房(ICU)接受监测。然而,近来越来越多的患者被安置在普通胸外科病房(GTW)。我们调查了肺癌肺叶切除术后在普通胸外科病房护理的安全性和有效性。
回顾了316例行肺癌肺叶切除术的患者。这些患者被分为两组:275例患者在ICU接受护理,41例患者术后立即在普通胸外科病房接受护理。在进行倾向评分匹配后,分析术后并发症和住院费用。对整个队列分析早期并发症的危险因素。
11例(3.5%)患者发生早期并发症(至术后第一天结束)。42例患者发生晚期并发症(13.3%)。倾向评分匹配后,两组早期并发症、晚期并发症及死亡率无差异。ICU组平均费用更高。早期并发症的危险因素是心脏合并症和一秒钟用力呼气量低。术后护理地点对结果无影响。
对于低风险患者,肺癌肺叶切除术后立即在普通胸外科病房护理是安全且具有成本效益的,且不影响治疗结果。