Lin Rongjia, Che Guowei
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
J Thorac Dis. 2018 Sep;10(9):5368-5375. doi: 10.21037/jtd.2018.08.54.
Cough is a common respiratory complication in non-small cell lung cancer (NSCLC) patients after surgery. Previous studies have proposed a number of risk factors for postoperative cough; however, these studies are mainly based on traditional thoracotomies and tend to lack adequate objective assessment methods. The purpose of this study was to identify the risk factors of cough in NSCLC patients after video-assisted thoracoscopic surgery (VATS) using the Leicester Cough Questionnaire in Mandarin Chinese (LCQ-MC) to evaluate postoperative cough.
A total of 198 NSCLC patients were enrolled. Overall, 91 patients (46.0%) developed cough after VATS, and 73 patients remained cough after 1 month. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors of postoperative cough.
The independent factors of postoperative cough included female sex [odds ratio (OR) 2.399, 95% confidence interval (CI): 1.260-4.565, P=0.008], duration of anesthesia (over 164 minutes; OR 2.810, 95% CI: 1.368-5.771, P=0.005), resection of the lower paratracheal nodes (OR 3.697, 95% CI: 1.439-9.499, P=0.007), and resection of the subcarinal nodes (OR 4.175, 95% CI: 1.203-14.495, P=0.024). The follow-up LCQ-MC total score after 1 month (18.00±1.80) was significantly higher than the postoperative total score (16.35±2.26; P=0.004).
Female sex, duration of anesthesia over 164 minutes, lower paratracheal node resection and subcarinal node resection were independent risk factors related to cough in NSCLC patients after VATS. In addition, the LCQ-MC performed satisfactorily in describing the longitudinal changes in cough symptoms.
咳嗽是非小细胞肺癌(NSCLC)患者术后常见的呼吸系统并发症。以往研究提出了一些术后咳嗽的危险因素;然而,这些研究主要基于传统开胸手术,且往往缺乏充分的客观评估方法。本研究旨在使用中文版莱斯特咳嗽问卷(LCQ-MC)评估非小细胞肺癌患者电视辅助胸腔镜手术(VATS)后咳嗽的危险因素。
共纳入198例非小细胞肺癌患者。总体而言,91例患者(46.0%)在VATS术后出现咳嗽,73例患者在1个月后仍有咳嗽。进行单因素和多因素逻辑回归分析以确定术后咳嗽的独立危险因素。
术后咳嗽的独立因素包括女性[比值比(OR)2.399,95%置信区间(CI):1.260 - 4.565,P = 0.008]、麻醉时间(超过164分钟;OR 2.810,95% CI:1.368 - 5.771,P = 0.005)、气管旁下淋巴结切除(OR 3.697,95% CI:1.439 - 9.499,P = 0.007)和隆突下淋巴结切除(OR 4.175,95% CI:1.203 - 14.495,P = 0.024)。1个月后的随访LCQ-MC总分(18.00±1.80)显著高于术后总分(16.35±2.26;P = 0.004)。
女性、麻醉时间超过164分钟、气管旁下淋巴结切除和隆突下淋巴结切除是VATS术后非小细胞肺癌患者咳嗽的独立危险因素。此外,LCQ-MC在描述咳嗽症状的纵向变化方面表现良好。