Wu Donghong, Liang Hengrui, Liang Wenhua, Liu Hui, Wang Chuqiao, Wen Yaokai, Jiang Yu, Su Zixuan, Peng Haoxin, Wang Runchen, Chen Yingying, Jiang Long, Zhao Yi, Wang Wei, Liu Jun, He Jianxing
Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Nanshan School, Guangzhou Medical University, Guangzhou, China.
Eur J Cardiothorac Surg. 2020 Sep 1;58(3):605-612. doi: 10.1093/ejcts/ezaa125.
The feasibility and safety of spontaneous ventilation (SV) video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer (NSCLC) in patients with excess body weight [defined as body mass index (BMI) ≥ 25 kg/m2] remain unclear.
Patients with NSCLC with excess body weight who underwent SV-VATS or mechanical ventilation (MV) VATS (MV-VATS) between April 2012 and July 2018 were analysed retrospectively. Propensity score matching was applied to balance the distribution of demographic characteristics. The short-term outcomes between the SV-VATS group and MV-VATS group were compared.
From April 2012 to July 2018, a total of 703 patients with excess body weight were included, 68 of whom underwent SV-VATS and 635 of whom underwent MV-VATS. After propensity score matching, the distribution of demographic characteristics was well balanced. BMIs (26.65 ± 1.74 vs 27.18 ± 2.36 kg/m2; P = 0.29) were similar between the groups. Patients who underwent SV-VATS had similar anaesthesia times (213 ± 57 vs 233 ± 67 min; P = 0.16) and similar operative times (122 ± 44 vs 142 ± 56 min; P = 0.086). The intraoperative bleeding volume, postoperative chest tube duration, volume of pleural drainage, number of dissected N1 and N2 station lymph nodes, length of hospitalization and incidence of complications were comparable between the 2 groups.
Primary lung cancer resection is feasible and not associated with safety issues under SV-VATS in selected patients with NSCLC with excess body weight.
对于体重超标（定义为体重指数[BMI]≥25kg/m²）的非小细胞肺癌（NSCLC）患者，自主通气（SV）电视辅助胸腔镜手术（VATS）的可行性和安全性尚不清楚。
回顾性分析2012年4月至2018年7月期间接受SV-VATS或机械通气（MV）VATS（MV-VATS）的体重超标NSCLC患者。采用倾向评分匹配法平衡人口统计学特征的分布。比较SV-VATS组和MV-VATS组的短期结局。
2012年4月至2018年7月，共纳入703例体重超标患者，其中68例行SV-VATS，635例行MV-VATS。倾向评分匹配后，人口统计学特征分布平衡良好。两组间BMI相似（26.65±1.74 vs 27.18±2.36kg/m²；P = 0.29）。接受SV-VATS的患者麻醉时间相似（213±57 vs 233±67分钟；P = 0.16），手术时间相似（122±44 vs 142±56分钟；P = 0.086）。两组术中出血量、术后胸管留置时间、胸腔引流量、N1和N2站淋巴结清扫数量、住院时间及并发症发生率相当。
对于部分体重超标NSCLC患者，在SV-VATS下进行原发性肺癌切除是可行的，且不存在安全问题。
