Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Interact Cardiovasc Thorac Surg. 2020 Oct 1;31(4):544-546. doi: 10.1093/icvts/ivaa144.
Reoperative pulmonary resection (with prior ipsilateral chest surgery) has been reported to be associated with a high rate of postoperative complications. The objective of this study was to evaluate prolonged air leak (PAL) after reoperative pulmonary resections. We conducted a single-centre retrospective analysis on 100 consecutive patients undergoing ipsilateral reoperative pulmonary resection at our institution between March 2012 and February 2020. We investigated the incidence of PAL after reoperative pulmonary resections in comparison to that after first operations and analysed potentially relevant factors of PAL after reoperations. After reoperations, the incidence of PAL was 24%. The incidence of PAL after reoperations was significantly higher than that after first operations (P < 0.01). On multivariable analysis, anatomical resection (P = 0.03) and thoracotomy approach (P = 0.02) were found to be significant factors associated with the occurrence of PAL, and age was a significant factor associated with chest tube duration (P < 0.01) and length of hospital stay (P < 0.01) after reoperative pulmonary resection. Our study identified significant risk factors of PAL after reoperative pulmonary resections, which would be an important step towards improved management of patients undergoing reoperative pulmonary resections.
再次肺切除术(既往同侧胸部手术)与术后高并发症发生率相关。本研究旨在评估再次肺切除术后持续性肺漏气(PAL)。我们对 2012 年 3 月至 2020 年 2 月我院 100 例同侧再次肺切除术患者进行了单中心回顾性分析。我们比较了再次肺切除术后和首次手术后 PAL 的发生率,并分析了再次手术后 PAL 的潜在相关因素。再次手术后 PAL 的发生率为 24%。再次手术后 PAL 的发生率明显高于首次手术后(P<0.01)。多变量分析显示,解剖性切除(P=0.03)和开胸入路(P=0.02)是 PAL 发生的显著相关因素,年龄是再次肺切除术后胸腔引流管时间(P<0.01)和住院时间(P<0.01)的显著相关因素。我们的研究确定了再次肺切除术后 PAL 的显著危险因素,这是改善再次肺切除术患者管理的重要一步。