Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan.
BMC Pulm Med. 2021 Apr 1;21(1):109. doi: 10.1186/s12890-021-01477-8.
Although repeat pulmonary resection (RPR) for multiple lung cancer has been performed for non-small cell lung cancer and metastatic lung tumor, with the prognostic benefit detailed in several reports, the risk of RPR has not been well analyzed.
Patients with lung malignancies who underwent complete resection at Kanazawa Medical University between January 2010 and October 2019 were analyzed. The relationship between postoperative complications and preoperative and perioperative factors was analyzed. Postoperative complications were categorized into five grades according to the Clavien-Dindo classification system.
A total of 41 patients who were received RPR were enrolled in this study. Primary lung tumor was found in 31 patients, and metastatic lung tumor was found in 10 patients. The postoperative complication rate of the first operation was 29%, and that of the second operation was 29%. While there were no significant factors for an increased incidence of postoperative complication in a multivariate analysis, an operation time over 2 h at the second operation tended to affect the incidence of postoperative complication (p = 0.06). Furthermore, the operation time was significantly longer (p = 0.02) and wound length tended to be longer (p = 0.07) in the ipsilateral group than in the contralateral group. The rate of postoperative complications and the length of the postoperative hospital stay were not significantly different between the two groups.
RPR is safely feasible and is not associated with an increased rate of postoperative complications, even on the ipsilateral side.
虽然重复肺切除术(RPR)已被用于治疗非小细胞肺癌和转移性肺肿瘤,并在一些报告中详细说明了其预后益处,但 RPR 的风险尚未得到很好的分析。
分析了 2010 年 1 月至 2019 年 10 月在金泽医科大学接受完全切除术的患有肺部恶性肿瘤的患者。分析了术后并发症与术前和围手术期因素之间的关系。根据 Clavien-Dindo 分类系统将术后并发症分为五个等级。
本研究共纳入 41 例接受 RPR 的患者。原发性肺部肿瘤 31 例,转移性肺部肿瘤 10 例。第一次手术的术后并发症发生率为 29%,第二次手术的术后并发症发生率为 29%。虽然多变量分析中没有发现术后并发症发生率增加的显著因素,但第二次手术的手术时间超过 2 小时可能会影响术后并发症的发生率(p=0.06)。此外,与对侧组相比,同侧组的手术时间明显更长(p=0.02),切口长度也有更长的趋势(p=0.07)。两组的术后并发症发生率和术后住院时间无显著差异。
即使在同侧,RPR 也是安全可行的,并且与术后并发症发生率增加无关。