Risk factors for major adverse events of video-assisted thoracic surgery lobectomy for lung cancer.
Risk factors for major adverse events of video-assisted thoracic surgery lobectomy for lung cancer.
复制标题
DOI：
10.7150/ijms.8912
复制
发表时间：
2014
影响因子：
3.6
通讯作者：
Jiang GN
中科院分区：
文献类型：
--
作者：
Yang J;Xia Y;Yang Y;Ni ZZ;He WX;Wang HF;Xu XX;Yang YL;Fei K;Jiang GN
目的：本研究的目的是确定电视胸腔镜肺叶切除术（VATS）治疗原发性肺癌的主要不良事件的危险因素。方法：2007年7月至2012年6月，1806例（1032例男性，57.1%）IA-IIIA期肺癌患者计划接受VATS肺叶切除术。采用胸部发病率和死亡率分类TM&M系统评估并发症的存在和严重程度。术后30天随访观察并发症。采用单因素和多因素分析主要不良事件的独立危险因素。结果：1806例胸腔镜肺叶切除术成功率为97.6%（1763/1806）。129例患者（7.3%）发生严重并发症，死亡率为0.3%（5/1763）。肺部并发症占主要并发症的90.7%，占死亡率的80%。Logistic回归分析显示，合并症、高龄、手术时间≥ 240 min、混合式电视胸腔镜手术是主要不良事件的预测因素（P<0.05）。混合和转换VATS肺叶切除术导致的主要不良事件比完全VATS高，分别为15.1%、20.9%和7.4%（P=0.013）。结论：电视胸腔镜肺叶切除术的总体并发症发生率和死亡率较低，但仍有严重并发症发生。肺部并发症是最常见的主要并发症和死亡原因。年龄≥ 70岁、合并症、手术时间≥ 240分钟和混合VATS是主要不良事件的预测因素。
Aims: The purpose of this study was to identify the risk factors for major adverse events of VATS (Video-Assisted Thoracic Surgery) lobectomy for primary lung cancer. Methods: 1806 Patients (1032 males, 57.1%) planned to undergo VATS lobectomy for stage IA-IIIA lung cancer from July 2007 to June 2012. The Thoracic Morbidity and Mortality Classification TM&M system was used to evaluate the presence and severity of complications. Postoperative complications were observed during a 30-day follow up. Univariate and multivariate analysis were used to analyze the independent risk factors for major adverse events. Results: Successful rate of VATS lobectomy was 97.6% (1763/1806). Major complications occurred in 129 patients (7.3%), with a mortality of 0.3% (5/1763). Pulmonary complications contribute up to 90.7% of the major complications and 80% of mortality. Logistic regression indicated that comorbidities, elder age ≥70y, operative time ≥240min and hybrid VATS were predictors for major adverse events (P<0.05). Hybrid and converted VATS lobectomy result in higher major adverse events compared with complete VATS, 15.1%, 20.9% and 7.4% respectively (P=0.013). Conclusions: The overall complication rate and mortality of VATS lobectomy are low, while major complications sometimes occur. Pulmonary complications are the most common major complications and cause of mortality. Age ≥70y, comorbidities, operative time ≥240min and Hybrid VATS are predictors of major adverse events.
登录
查看更多内容
影响因子：
4.6
作者：
Kim, Kwhanmien;Kim, Hong Kwan;Shim, Young Mog
通讯作者：
Shim, Young Mog
影响因子：
4.6
作者：
Whitson, Bryan A.;Groth, Shawn S.;Maddaus, Michael A.
通讯作者：
Maddaus, Michael A.
DOI：
10.5090/kjtcs.2011.44.1.32
发表时间：
2011-02-01
期刊：
The Korean journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Park, Joon Suk;Kim, Kwhanmien;Han, Woo-Sik
通讯作者：
Han, Woo-Sik
DOI：
10.1016/j.jtcvs.2006.03.058
发表时间：
2006-09-01
影响因子：
6
作者：
Shigemura, Norihisa;Akashi, Akinori;Sawa, Yoshiki
通讯作者：
Sawa, Yoshiki
影响因子：
4.6
作者：
Ivanovic, Jelena;Al-Hussaini, Ahmed;Seely, Andrew J. E.
通讯作者：
Seely, Andrew J. E.