Yang Rong, Wu Yihe, Yao Linpeng, Xu Jinming, Zhang Siying, Du Chengli, Chen Feng
Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China,
Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
Ther Clin Risk Manag. 2019 Feb 4;15:223-231. doi: 10.2147/TCRM.S195010. eCollection 2019.
This study investigated the perioperative risk factors of postoperative pulmonary complications (PPCs) after minimally invasive anatomic resection for lung cancer.
We retrospectively reviewed the data from medical records of 729 lung cancer patients undergoing minimally invasive anatomic lung resections between January 2017 and December 2017. Univariate and binary logistic regression analyses were performed to select the independent risk factors for PPCs during the patient's postoperative hospitalization after surgery.
The incidence of PPCs was 24.8% (n=181/729). No patient died during the period of hospitalization. Logistic regression analysis revealed that body mass index (BMI) ≥24.0 kg/m (vs <24.0 kg/m: OR 1.514, 95% CI 1.057-2.167, =0.024), single segmentectomy (vs single lobectomy: OR 2.115, 95% CI 1.150-3.891, =0.016), bilobectomy or combined lobectomy and segmentectomy (vs single lobectomy: OR 2.731, 95% CI 1.013-7.361, =0.047), and right lung lobe surgery (vs left lung lobe surgery: OR 1.519, 95% CI 1.046-2.205, =0.028) were independent risk factors for PPCs in lung cancer patients who received minimally invasive anatomic lung resections.
Individual factors such as BMI ≥24.0 kg/m, single segmentectomy, bilobectomy or combined lobectomy and segmentectomy, and right lung lobe surgery were independent risk factors of PPCs, which should be helpful for risk stratification, patient counseling, and perioperative care for lung cancer patients.
本研究调查了肺癌微创解剖性切除术后肺部并发症(PPCs)的围手术期危险因素。
我们回顾性分析了2017年1月至2017年12月期间729例行微创解剖性肺切除术的肺癌患者的病历资料。进行单因素和二元逻辑回归分析,以选择患者术后住院期间发生PPCs的独立危险因素。
PPCs的发生率为24.8%(n = 181/729)。住院期间无患者死亡。逻辑回归分析显示,体重指数(BMI)≥24.0 kg/m(vs <24.0 kg/m:OR 1.514,95%CI 1.057 - 2.167,P = 0.024)、单段切除术(vs 单叶切除术:OR 2.115,95%CI 1.150 - 3.891,P = 0.016)、双叶切除术或联合叶切除术和段切除术(vs 单叶切除术:OR 2.731,95%CI 1.013 - 7.361,P = 0.047)以及右肺叶手术(vs 左肺叶手术:OR 1.519,95%CI 1.046 - 2.205,P = 0.028)是接受微创解剖性肺切除术的肺癌患者发生PPCs的独立危险因素。
BMI≥24.0 kg/m、单段切除术、双叶切除术或联合叶切除术和段切除术以及右肺叶手术等个体因素是PPCs的独立危险因素,这有助于对肺癌患者进行风险分层、患者咨询和围手术期护理。