Petrella Francesco, Casiraghi Monica, Radice Davide, Bardoni Claudia, Cara Andrea, Mohamed Shehab, Sances Daniele, Spaggiari Lorenzo
Department of Thoracic Surgery, IRCCS European Institute of Oncology, 20141 Milan, Italy.
Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.
Cancers (Basel). 2022 Apr 20;14(9):2064. doi: 10.3390/cancers14092064.
Background: An unplanned return to the operating room (UROR) is defined as a readmission to the operating room because of a complication or an untoward outcome related to the initial surgery. The aim of the present report is to evaluate the role of URORs after elective oncologic thoracic surgery. Methods: In the study, 4012 consecutive patients were enrolled; among them, 71 patients (1.76%) had an unplanned return to the operating room. Age, sex, Charlson comorbidity index, induction treatments, type of the first operation, indication to readmission to the operating room and type of second operation, length of stay, complication after reoperation and outcomes were collected. Results: The mean age was 63.3 (SD: 13.0); there were 53 male patients (74.6%); the type of the first procedure was: lower lobectomy (11.3%), middle lobectomy (1.4%), upper lobectomy (22.5%), metastasectomy (5.6%), extrapleural pneumonectomy (4.2%), pneumonectomy (40.9%), pleural biopsy (5.6%) and other procedures (8.5%). Patients presenting complications after UROR had undergone a significantly longer first procedure (p < 0.02), had a longer length of stay (p < 0.001) and had higher post-operative mortality (p < 0.001). Conclusions: The patients experiencing UROR after elective oncologic thoracic surgery have significantly higher morbidity and mortality rates when compared to standard thoracic surgery. Bronchopleural fistula remains the most lethal complication in patients undergoing UROR.
非计划重返手术室（UROR）被定义为因与初次手术相关的并发症或不良后果而再次进入手术室。本报告的目的是评估择期肿瘤性胸外科手术后非计划重返手术室的作用。方法：在该研究中，连续纳入了4012例患者；其中，71例患者（1.76%）非计划重返手术室。收集了患者的年龄、性别、Charlson合并症指数、诱导治疗、首次手术类型、重返手术室的指征和二次手术类型、住院时间、再次手术后的并发症及结局。结果：平均年龄为63.3岁（标准差：13.0）；男性患者53例（74.6%）；首次手术类型为：下叶切除术（11.3%）、中叶切除术（1.4%）、上叶切除术（22.5%）、转移瘤切除术（5.6%）、胸膜外全肺切除术（4.2%）、全肺切除术（40.9%）、胸膜活检（5.6%）和其他手术（8.5%）。非计划重返手术室后出现并发症的患者首次手术时间明显更长（p < 0.02），住院时间更长（p < 0.001），术后死亡率更高（p < 0.001）。结论：与标准胸外科手术相比，择期肿瘤性胸外科手术后非计划重返手术室的患者发病率和死亡率明显更高。支气管胸膜瘘仍然是非计划重返手术室患者中最致命的并发症。
