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评价影响肺切除术患者发病率和死亡率的因素。

Evaluation of factors affecting morbidity and mortality in pneumonectomy patients.

机构信息

Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Acta Chir Belg. 2021 Oct;121(5):301-307. doi: 10.1080/00015458.2020.1753147. Epub 2020 Apr 16.

Abstract

BACKGROUND

The aim of this study was to evaluate risk factors associated with morbidity and mortality after pneumonectomy in non-small cell lung cancer patients.

METHODS

The study included 107 patients who underwent pneumonectomy for non-small cell lung cancer between January 2013 and December 2018. Prognostic factors affecting mortality and morbidity were investigated.

RESULTS

The patient group included 10 women (9.3%) and 97 men (90.7%) with a mean age of 59.5 ± 8.5 years. Seventy-three patients (68.2%) underwent standard pneumonectomy and 34 (31.8%) underwent extended pneumonectomy. Nine patients (8.4%) received induction chemotherapy. Complications occurred in 33 patients (30.8%). Complications were classified as surgical, cardiovascular, pulmonary, or infectious. Charlson Comorbidity Index (CCI) > 3 and right-side resection were significant risk factors for the development of complications. The most common complication was atrial fibrillation. Eleven patients developed a bronchopleural fistula. The 30-day postoperative mortality rate was 6.5% ( = 7). Mortality was not associated with any demographic and surgical characteristics other than CCI > 3 ( = .05).

CONCLUSION

The results of this study indicate that our pneumonectomy outcomes are acceptable despite high morbidity and mortality rates. Appropriate patient selection for pneumonectomy is as important as complication management. High-comorbidity patients should undergo these procedures in experienced centers.

摘要

背景

本研究旨在评估非小细胞肺癌患者行肺切除术相关发病率和死亡率的危险因素。

方法

本研究纳入了 2013 年 1 月至 2018 年 12 月期间因非小细胞肺癌行肺切除术的 107 例患者。研究了影响死亡率和发病率的预后因素。

结果

患者组包括 10 名女性(9.3%)和 97 名男性(90.7%),平均年龄为 59.5±8.5 岁。73 例(68.2%)患者行标准肺切除术,34 例(31.8%)患者行扩大肺切除术。9 例(8.4%)患者接受了诱导化疗。33 例患者发生了并发症(30.8%)。并发症分为手术、心血管、肺部或感染性。Charlson 合并症指数(CCI)>3 和右侧切除是发生并发症的显著危险因素。最常见的并发症是心房颤动。11 例患者发生支气管胸膜瘘。30 天术后死亡率为 6.5%(=7)。死亡率与 CCI>3 以外的任何人口统计学和手术特征无关(=0.05)。

结论

尽管本研究的发病率和死亡率较高,但我们的肺切除术结果是可以接受的。适当选择肺切除术患者与处理并发症同样重要。高合并症患者应在有经验的中心进行这些手术。

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