Complications following lung surgery in the Dutch-Belgian randomized lung cancer screening trial.
Complications following lung surgery in the Dutch-Belgian randomized lung cancer screening trial.
复制标题
荷兰-比利时随机肺癌筛查试验中肺部手术后的并发症。
DOI：
10.1093/ejcts/ezs081
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
R. V. van Klaveren
中科院分区：
文献类型：
--
作者：
S. V. van't Westeinde;N. Horeweg;P. De Leyn;H. Groen;J. Lammers;C. Weenink;K. Nackaerts;R. V. van Klaveren
目标
旨在评估接受手术切除的 NELSON 肺癌筛查试验筛查组参与者的并发症发生率，并根据文献综述调查手术后的并发症发生率、住院时间、再次开胸手术和死亡率是否与非筛查组不同，同时考虑到合并症。
方法
2004年4月至2008年12月期间，198名受试者接受了胸外科手术。从医疗记录中检索共病情况。术后并发症分为轻微和严重。
结果
总共进行了 182 例开胸手术、5 例电视辅助胸腔镜手术 (VATS) 后开胸手术和 11 例 VATS 手术。在这些患者中，36%患有慢性阻塞性肺病，16%患有冠状动脉疾病，14%患有糖尿病，11%患有外周血管疾病。开胸术后，47% (88/187) 出现 ≥1 种轻微并发症（文献中为 7-57%），10% (18/187) 出现 ≥1 种主要并发症（文献中为 2-26%）； VATS 后，38% (6/16) 出现≥1 种轻微并发症，但没有严重并发症。在接受良性疾病手术的受试者中，有 17% (3/18) 的主要并发症和 21% (20/96) 的轻微并发症。再次开胸率为 3%，开胸或 VATS 后无 30 天死亡率（文献中为 0-8.3%）。与非筛查系列（0-8.3%）相比，手术后0%的死亡率较低；与非筛查系列（8.5-58%）相比，并发症发生率（53%）在范围内。
结论
总之，NELSON 肺癌筛查试验中手术后的死亡率低于非筛查系列中的死亡率。并发症发生率与非筛查系列在同一范围内。
试用注册号
ISR CTN 63545820。
OBJECTIVES
To assess the complication rate in participants of the screen arm of the NELSON lung cancer screening trial who underwent surgical resection and to investigate, based on a literature review, whether the complication rate, length of hospital stay, re-thoracotomy and mortality rates after a surgical procedure were different from those of the non-screening series, taking co-morbidity into account.
METHODS
Between April 2004 and December 2008, 198 subjects underwent thoracic surgery. Co-morbid conditions were retrieved from the medical records. Postoperative complications were classified as minor and major.
RESULTS
In total, 182 thoracotomies, 5 thoracotomies after video-assisted thoracoscopic surgery (VATS) and 11 VATS procedures were performed. In these patients, 36% had chronic obstructive lung disease, 16% coronary artery disease, 14% diabetes mellitus and 11% peripheral vascular disease. Following thoracotomy, 47% (88/187) had ≥1 minor (7-57% in literature) and 10% (18/187) ≥1 major complication (2-26% in literature); following VATS, 38% (6/16) had ≥1 minor complication, but no major complications. Seventeen per cent (3/18) of major complications and 21% (20/96) of minor complications were seen in subjects operated for benign disease. The re-thoracotomy rate was 3% and there was no 30-day mortality after thoracotomy or VATS (0-8.3% in literature). The mortality rate of 0% after surgical procedures is low when compared with the non-screening series (0-8.3%); the rate of complications (53%) is within range when compared with the non-screening series (8.5-58%).
CONCLUSIONS
In conclusion, mortality rates after surgical procedures are lower in the NELSON lung cancer screening trial than those in the non-screening series. The rate of complications is within the same range as in the non-screening series.
TRIAL REGISTRATION NUMBER
ISR CTN 63545820.
影响因子：
37.8
作者：
Lee, TH;Marcantonio, ER;Goldman, L
通讯作者：
Goldman, L
影响因子：
158.5
作者：
Bach, PB;Cramer, LD;Begg, CB
通讯作者：
Begg, CB