Ueda Takuya, Suzuki Kenji, Matsunaga Takeshi, Takamochi Kazuya, Oh Shiaki
Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan.
Gen Thorac Cardiovasc Surg. 2018 Feb;66(2):95-100. doi: 10.1007/s11748-017-0858-x. Epub 2017 Nov 13.
The aim of this study was to elucidate the characteristics and predictors of postoperative atrial fibrillation (POAF) from the standpoint of surgical mode.
Retrospective analysis was carried out on 607 patients who underwent lobectomy or segmentectomy for clinical stage IA lung cancer. We investigated the clinical factors to determine the predictors of the development of POAF.
Of the 607 patients, 443 underwent lobectomy, and 164 underwent segmentectomy. POAF developed in 37 patients. Of these, 34 (7.7%) were in the lobectomy group, and 3 (1.8%) in the segmentectomy group. In the univariate analysis for predictors of POAF, age (p < 0.01), history of ischemic heart disease (p = 0.03), FEV1.0% (p < 0.01) and surgical mode (p = 0.01) showed significant differences between the groups. The multivariate analysis revealed that increasing age (p < 0.01, HR 1.059, CI 1.015-1.106), surgical mode (p = 0.02, HR 5.734, CI 1.350-24.361) and FEV1.0% < 70% (p = 0.03, HR 2.182, CI 1.067-4.461) were independent predictors of POAF.
POAF was significantly less following segmentectomy compared with lobectomy.
本研究旨在从手术方式的角度阐明术后房颤（POAF）的特征及预测因素。
对607例因临床ⅠA期肺癌接受肺叶切除术或肺段切除术的患者进行回顾性分析。我们调查了临床因素以确定POAF发生的预测因素。
607例患者中，443例行肺叶切除术，164例行肺段切除术。37例患者发生POAF。其中，34例（7.7%）在肺叶切除组，3例（1.8%）在肺段切除组。在POAF预测因素的单因素分析中，年龄（p＜0.01）、缺血性心脏病史（p = 0.03）、第1秒用力呼气容积百分比（FEV1.0%）（p＜0.01）和手术方式（p = 0.01）在两组间显示出显著差异。多因素分析显示，年龄增长（p＜0.01，HR 1.059，CI 1.015 - 1.106）、手术方式（p = 0.02，HR 5.734，CI 1.350 - 24.361）和FEV1.0%＜70%（p = 0.03，HR 2.182，CI 1.067 - 4.461）是POAF的独立预测因素。
与肺叶切除术相比，肺段切除术后POAF的发生率显著更低。
