Li Pengfei, Lai Yutian, Zhou Kun, Che Guowei
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhongguo Fei Ai Za Zhi. 2017 Apr 20;20(4):264-271. doi: 10.3779/j.issn.1009-3419.2017.04.07.
Postoperative complications (PCs) are contributing factors to patient mortality following lung resection. In this retrospective study, the Clavien-Dindo classification was used to analyze the current incidence of PCs and identify the risk factors of different grades of PCs.
A total of 966 lung cancer patients who underwent lobectomy in our department between June 2013 and December 2014 were retrospectively enrolled. Patients were divided into two groups depending on the occurrence of PCs. The PCs were classified into four grades through the Clavien-Dindo classification, and the related risk factors of different grades were evaluated.
Approximately 15.0% (145/966) of patients had PC (total incidence: 39.3%, 380/966). Among the 380 cases with PCs, the proportions of Clavien-Dindo grade I, grade II, grade III and grade IV or above complications were 6.8%, 75.3%, 15.0% and 2.9%, respectively. Binary Logistic regressions showed that preoperative forced expiratory volume in one second (FEV1), diffusion capacity for carbon monoxide of the lung (single breath)(DLco SB), and preoperative combined chronic obstructive pulmonary disease were the significant independent factors for PCs. FEV1 in preoperative pulmonary function was the significant risk factor for complications at Clavien-Dindo grade I, grade II, grade III, and above.
Clavien-Dindo grade II complications are the most common complications within 30 days after lung cancer lobectomy. FEV1 is closely related to the occurrence of PCs and may potentially be one of the practical variables to assess the risk of occurrence of PCs.
术后并发症是肺切除术后患者死亡的促成因素。在这项回顾性研究中,采用Clavien-Dindo分类法分析术后并发症的当前发生率,并确定不同等级术后并发症的危险因素。
回顾性纳入2013年6月至2014年12月在我科接受肺叶切除术的966例肺癌患者。根据术后并发症的发生情况将患者分为两组。通过Clavien-Dindo分类法将术后并发症分为四个等级,并评估不同等级的相关危险因素。
约15.0%(145/966)的患者发生了术后并发症(总发生率:39.3%,380/966)。在380例发生术后并发症的病例中,Clavien-Dindo I级、II级、III级和IV级及以上并发症的比例分别为6.8%、75.3%、15.0%和2.9%。二元Logistic回归显示,术前一秒用力呼气量(FEV1)、肺一氧化碳弥散量(单次呼吸)(DLco SB)和术前合并慢性阻塞性肺疾病是术后并发症的显著独立危险因素。术前肺功能中的FEV1是Clavien-Dindo I级、II级、III级及以上并发症的显著危险因素。
Clavien-Dindo II级并发症是肺癌肺叶切除术后30天内最常见的并发症。FEV1与术后并发症的发生密切相关,可能是评估术后并发症发生风险的实际变量之一。