University of S Florida Health, Morsani College of Medicine, Tampa, FL.
Moffitt Cancer Center, Department of Thoracic Oncology, Tampa, FL.
JSLS. 2021 Jul-Sep;25(3). doi: 10.4293/JSLS.2021.00043.
Lower pre-albumin levels have been associated with increased rates of post-surgical complications, prolonged hospital length of stay (LOS), and death. This study aims to investigate the effect of postoperative pre-albumin levels on perioperative and long-term outcomes following robotic-assisted video thoracoscopic (RAVT) pulmonary lobectomy.
We retrospectively reviewed 459 consecutive patients who underwent RAVT pulmonary lobectomy by one surgeon for known or suspected lung cancer. The lowest pre-albumin values during the postoperative hospital stay were recorded. Twenty-three patients with no pre-albumin levels available were excluded from analysis. Patients were grouped as having normal (≥ 15 mg/dL) versus low (< 15mg/dL) pre-albumin. Outcomes and demographics were compared between groups using Pearson χ, Student's t, or Kruskal-Wallis tests. Univariate and multivariate generalized linear regression, logistic regression, or Cox proportional hazard ratio models were used to assess the association between outcomes and variables of interest. Kaplan-Meier analyses were performed to estimate and depict survival probabilities for each group.
Our study population comprised 436 patients. Lowest postoperative pre-albumin below 15 mg/dL was associated with more postoperative complications (44.2% vs 24.9%, p < 0.001), longer chest tube duration (6.9 vs 4.6 days, p = 0.001), and longer LOS (7.0 vs. 4.4 days, p < 0.001). In survival analysis, lowest perioperative pre-albumin levels were found to correlate with decreased 1 year (p = 0.012), 3-year (p = 0.001), and 5-year survival (p = 0.001).
Lower pre-albumin levels postoperatively are associated with more postoperative complications, longer chest tube duration and LOS, and decreased overall survival following robotic-assisted pulmonary lobectomy.
低前白蛋白水平与术后并发症发生率增加、住院时间延长（LOS）和死亡有关。本研究旨在探讨术后前白蛋白水平对机器人辅助电视胸腔镜（RAVT）肺叶切除术后围手术期和长期结局的影响。
我们回顾性分析了 459 例由一位外科医生为已知或疑似肺癌行 RAVT 肺叶切除术的连续患者。记录术后住院期间最低的前白蛋白值。由于没有前白蛋白水平，23 例患者被排除在分析之外。将患者分为正常（≥ 15mg/dL）与低（< 15mg/dL）前白蛋白组。使用 Pearson χ ²、Student's t 或 Kruskal-Wallis 检验比较组间的结果和人口统计学特征。使用单变量和多变量广义线性回归、逻辑回归或 Cox 比例风险比模型评估结果与感兴趣变量之间的关系。 Kaplan-Meier 分析用于估计和描绘每组的生存概率。
我们的研究人群包括 436 例患者。术后前白蛋白最低值低于 15mg/dL 与更多的术后并发症（44.2%比 24.9%，p < 0.001）、更长的胸腔引流管时间（6.9 比 4.6 天，p = 0.001）和更长的 LOS（7.0 比 4.4 天，p < 0.001）相关。在生存分析中，发现最低的围手术期前白蛋白水平与 1 年（p = 0.012）、3 年（p = 0.001）和 5 年生存率（p = 0.001）降低相关。
术后前白蛋白水平较低与机器人辅助肺叶切除术后更多的术后并发症、更长的胸腔引流管时间和 LOS 以及总生存率降低相关。
