Department of Cardiovascular and Respiratory Sciences, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Department of General and Specialistic Surgery 'P Stefanini', Sapienza University, Rome, Italy.
J Int Med Res. 2022 Jun;50(6):3000605221094531. doi: 10.1177/03000605221094531.
Only approximately 15% of patients with lung cancer are suitable for surgery and clinical postoperative outcomes vary. The aim of this study was to investigate variables associated with post-surgery respiratory failure in this patient cohort.
Patients who underwent surgery for lung cancer were retrospectively studied for respiratory function. All patients had undergone lung resection by a mini-thoracotomy approach. The study population was divided into two subgroups for comparison: lobectomy group, who underwent lobar resection; and sub-lobar resection group.
A total of 85 patients were included, with a prevalence of lung cancer stage IA and adenocarcinoma histotype. Lobectomy (versus sub-lobar resection), the presence of chronic obstructive pulmonary disease (COPD), and a COPD assessment test (CAT) score >10, were all associated with an increased risk of respiratory failure. The partial pressure of arterial oxygen decreased more in the lobectomy group than in the sub-lobar resection group following surgery, with a significant postoperative between-group difference in values. Postoperative CAT scores were also better in the sub-lobar resection group.
Post-surgical variations in functional parameters were greater in the group treated by lobectomy. COPD, high CAT score and surgery type were associated with postoperative development of respiratory failure.
仅有约 15%的肺癌患者适合手术，且临床术后结果存在差异。本研究旨在调查该患者队列中与术后呼吸衰竭相关的变量。
回顾性研究了接受肺癌手术的患者的呼吸功能。所有患者均通过小开胸术进行肺切除术。研究人群分为两组进行比较：肺叶切除术组，行肺叶切除术；以及亚肺叶切除术组。
共纳入 85 例患者，肺癌分期为 IA 期，组织学类型为腺癌。肺叶切除术（与亚肺叶切除术相比）、慢性阻塞性肺疾病（COPD）的存在以及 COPD 评估测试（CAT）评分>10 均与呼吸衰竭风险增加相关。与亚肺叶切除术组相比，肺叶切除术组术后动脉血氧分压下降更多，术后两组间存在显著差异。术后 CAT 评分也在亚肺叶切除术组中更好。
肺叶切除术组术后功能参数的变化更大。COPD、高 CAT 评分和手术类型与术后呼吸衰竭的发生相关。
