Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Eur J Cardiothorac Surg. 2024 Mar 29;65(4). doi: 10.1093/ejcts/ezae120.
To investigate the postoperative outcomes of lung resection in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and determine the optimal timing of surgery.
This retrospective, single-centre cohort study included patients who underwent lung resection between June 2021 and June 2022. Patients were divided into the coronavirus disease 2019 (COVID-19) and non-COVID-19 groups based on their preoperative SARS-CoV-2 infection history, and postoperative outcomes were compared. Logistic regression analysis was conducted to identify the risk factors of complications after lung resection surgery.
In total, 1194 patients were enrolled, of whom, 79 had a history of SARS-CoV-2 infection. In the COVID-19 group, 66 patients (90.4%) had received at least 1 vaccination dose. The average interval between infection and surgery was 67 days, with no significant impact on postoperative outcomes. Regarding postoperative outcomes, there were no significant differences in major complication rate (6.3% vs 5.4%, P = 0.613), respiratory complication rate (19.0% vs 12.2%, P = 0.079) or length of stays (4.9 ± 3.4 vs 5.0 ± 5.6, P = 0.992) between the 2 groups. Multivariate logistic regression analysis revealed that age, male sex, poor pulmonary function test, open surgery and extensive lung resection were risk factors for postoperative complications, while preoperative COVID-19 infection status was not a statistically significant risk factor.
In the post-vaccination era, lung resection surgery can be safely performed shortly after SARS-CoV-2 infection, even within 4 weeks of infection.
研究严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染患者肺切除术后的结局,并确定手术的最佳时机。
这是一项回顾性单中心队列研究,纳入了 2021 年 6 月至 2022 年 6 月期间接受肺切除术的患者。根据术前 SARS-CoV-2 感染史,患者分为新冠肺炎(COVID-19)组和非 COVID-19 组,比较术后结局。采用 Logistic 回归分析确定肺切除术后并发症的危险因素。
共纳入 1194 例患者,其中 79 例有 SARS-CoV-2 感染史。在 COVID-19 组中,66 例(90.4%)至少接种了 1 剂疫苗。感染与手术的平均间隔为 67 天,对术后结局无显著影响。在术后结局方面,两组间主要并发症发生率(6.3% vs. 5.4%,P=0.613)、呼吸系统并发症发生率(19.0% vs. 12.2%,P=0.079)或住院时间(4.9±3.4 vs. 5.0±5.6,P=0.992)均无显著差异。多变量 Logistic 回归分析显示,年龄、男性、肺功能测试不佳、开放性手术和广泛肺切除术是术后并发症的危险因素,而术前 COVID-19 感染状态不是统计学上的危险因素。
在接种疫苗后时代,SARS-CoV-2 感染后不久即可安全进行肺切除术,甚至在感染后 4 周内也可进行。