Morbidities of lung cancer surgery in obese patients.
Morbidities of lung cancer surgery in obese patients.
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DOI：
10.1016/j.jtcvs.2013.02.083
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发表时间：
2013-08
期刊：
影响因子：
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通讯作者：
Santana-Davila R
中科院分区：
文献类型：
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作者：
Dhakal B;Eastwood D;Sukumaran S;Hassler G;Tisol W;Gasparri M;Choong N;Santana-Davila R
Obesity is a risk factor for increased peri-operative morbidity and mortality in surgical patients. There have been limited studies to correlate the morbidity of lung cancer resection with obesity. We performed a retrospective study of patients who underwent surgical resection for lung cancer at the Medical College of Wisconsin from 2006 to 2010. Data on patient demographics, weight, pathology findings and hospital course were abstracted after appropriate IRB approval. Peri-operative morbidity was defined as atrial fibrillation, heart failure, respiratory failure, pulmonary embolism or any medical complications arising within 30 days after surgery. Fisher’s exact test was used to test the association between BMI and peri-operative morbidities. Between 2006 and 2010,320 lung resections were performed for lung cancer. Median age was 67(IQR 59–75) years and 185(57.8%) were females.121 (37.8%) patients had a BMI<25 and 199(62.18%) patients had a BMI≥25. The 30-day mortality rate was 1.8 % (n=6) in the whole group; only 2 of these patients had a BMI ≥ 25. Peri-operative morbidity occurred in 28(23.14%) of normal BMI patients and in 47(23.61%) of BMI ≥ 25 patients (p=0.54). Specific morbidities encountered by patients with normal vs. BMI ≥ 25 were: atrial fibrillation 11(9.09%) vs. 24(12.06%) (p=0.46), Pulmonary embolism 1(0.83%) vs. 3(1.51%) (p=1.0), congestive heart failure 2(1.65%) vs. 2(1.01%) (p=0.63), renal failure 4(3.3%) vs.2 (1.0%)(p=0.29), respiratory failure 12(9.92%) vs. 17(8.54%) (p=0.69) and acute respiratory distress syndrome 2(1.65%) vs. 1(0.50%) (p=0.55). Median hospital stay was 5 days in the lower BMI group and 4 days in the BMI ≥25 groups (p=0.52). Overweight and normal weight patients do not differ significantly in rates of perioperative morbidities, 30-day mortality and length of stay. Our study indicates that potential curative surgical resections can be offered to even significantly overweight patients.
