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袖状肺叶切除术后预防性纤维支气管镜检查可降低术后肺炎的发生率:一项倾向评分匹配研究。

Prophylactic fiberoptic bronchoscopy after sleeve lobectomy can reduce the incidence of postoperative pneumonia: a propensity score matching study.

作者信息

Cao Jie, Peng Zhiyu, Lin Huahang, Huang Zhaokang, Liu Zetao, Pu Qiang, Liu Lunxu, Guo Chenglin, Mei Jiandong

机构信息

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.

Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.

出版信息

J Thorac Dis. 2024 Dec 31;16(12):8503-8512. doi: 10.21037/jtd-24-1326. Epub 2024 Dec 16.

Abstract

BACKGROUND

Postoperative pneumonia (POP) predicts poor outcomes after lung surgery, especially for patients undergoing sleeve lobectomy. Fiberoptic bronchoscopy (FOB) is frequently used in the treatment of POP for patients receiving sleeve lobectomy. This study aimed to assess the effect of prophylactic FOB on the incidence of POP in these patients.

METHODS

This is a single-center retrospective cohort study. Postoperative outcomes of patients who underwent sleeve lobectomy for central lung cancer from August 2005 to August 2020 in the West China Hospital were collected. The included patients were divided into two groups based on whether prophylactic FOB was performed, and the two groups were compared using propensity score matching (PSM).

RESULTS

A total of 314 patients were included in this study. There were 166 patients in the aspirated group and 148 patients in the non-aspirated group. PSM resulted in 133 patients in each group. The aspirated group was associated with a lower incidence of POP (7.5% 17.3%; P=0.03), shorter duration of antibiotic use (5.6±3.3 6.9±3.9 days; P=0.003), and shorter postoperative hospital stay (9.3±4.8 10.7±5.5 days; P=0.04).

CONCLUSIONS

Prophylactic FOB after sleeve lobectomy was associated with improved postoperative outcomes and might be recommended for patients undergoing sleeve lobectomy.

摘要

背景

术后肺炎(POP)预示着肺手术后的不良预后,尤其是对于接受袖状肺叶切除术的患者。纤维支气管镜检查(FOB)常用于接受袖状肺叶切除术患者的POP治疗。本研究旨在评估预防性FOB对这些患者POP发生率的影响。

方法

这是一项单中心回顾性队列研究。收集了2005年8月至2020年8月在华西医院因中央型肺癌接受袖状肺叶切除术患者的术后结果。根据是否进行预防性FOB将纳入的患者分为两组,并使用倾向得分匹配(PSM)对两组进行比较。

结果

本研究共纳入314例患者。抽吸组有166例患者,非抽吸组有148例患者。PSM后每组有133例患者。抽吸组的POP发生率较低(7.5%对17.3%;P = 0.03),抗生素使用时间较短(5.6±3.3天对6.9±3.9天;P = 0.003),术后住院时间较短(9.3±4.8天对10.7±5.5天;P = 0.04)。

结论

袖状肺叶切除术后预防性FOB与改善术后结果相关,可能推荐给接受袖状肺叶切除术的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a46e/11740041/23db453185cd/jtd-16-12-8503-f1.jpg

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