Chen Wei, Zheng Qiangqiang, Shen Yi, Liang Min, Yuan Yang, Lu Yusong, Zhou Yunfeng
Department of Thoracic Surgery, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610044, P.R. China.
J Cardiothorac Surg. 2024 Dec 30;19(1):689. doi: 10.1186/s13019-024-03211-x.
Compare the differences in perioperative clinical characteristics of lung cancer patients of different genders who have undergone VATS lobectomy, and explore the impact of these differences on the short-term prognosis of patients.
A total of 338 consecutive patients with lung cancer who underwent VATS lobectomy in our hospital from August 2021 to August 2022 were retrospectively analyzed, they were divided into male group and female group. The perioperative characteristics and short-term prognosis of different groups were compared. The multivariate binary logistic regression analysis was used to analyze the risk factors.
There were statistically significant differences between male and female patients in age of onset, body surface area (BSA), smoking rate, alcohol consumption rate, hypertension incidence, pulmonary function and clinical stage. There were statistically significant differences between male and female patients in operation time and lymph node dissection. The probability of postoperative complications, such as pulmonary infection, persistent air leakage and severe subcutaneous emphysema, in male patients was significantly higher than that in female patients. The average daily postoperative thoracic drainage volume in male patients was considerably higher than that in female patients, and the postoperative duration of thoracic drainage tube and hospital stay in male patients were significantly longer than those in female patients. After multiple regression analysis, low FEVI values in males was found to be an independent risk factor for postoperative complications.
Compared with female patients, male patients with lung cancer are more likely to have unfavorable factors such as older age, higher smoking rate, poor pulmonary function and late clinical stage of tumors when they undergoing VATS surgery treatment. The appropriate thoracic drainage time can be selected according to gender differences to shorten the length of hospital stay. The incidence of postoperative complications is higher in male patients, especially those with poor pulmonary function, and active perioperative intervention is required to reduce the incidence of postoperative complications.
比较接受电视辅助胸腔镜肺叶切除术的不同性别肺癌患者围手术期临床特征的差异，并探讨这些差异对患者短期预后的影响。
回顾性分析2021年8月至2022年8月在我院接受电视辅助胸腔镜肺叶切除术的338例连续肺癌患者，将其分为男性组和女性组。比较不同组的围手术期特征和短期预后。采用多因素二元逻辑回归分析危险因素。
男性和女性患者在发病年龄、体表面积（BSA）、吸烟率、饮酒率、高血压发病率、肺功能和临床分期方面存在统计学显著差异。男性和女性患者在手术时间和淋巴结清扫方面存在统计学显著差异。男性患者术后发生肺部感染、持续性漏气和严重皮下气肿等并发症的概率明显高于女性患者。男性患者术后胸腔平均每日引流量明显高于女性患者，男性患者术后胸腔引流管留置时间和住院时间明显长于女性患者。多元回归分析后发现，男性患者低FEV1值是术后并发症的独立危险因素。
与女性患者相比，男性肺癌患者在接受电视辅助胸腔镜手术治疗时，更易出现年龄较大、吸烟率较高、肺功能较差和肿瘤临床分期较晚等不利因素。可根据性别差异选择合适的胸腔引流时间，以缩短住院时间。男性患者术后并发症发生率较高，尤其是肺功能较差者，需要围手术期积极干预以降低术后并发症发生率。
