Risk factors of postoperative pulmonary complications after minimally invasive anatomic resection for lung cancer

• Main Authors: Yang R, Wu Y, Yao L, Xu J, Zhang S, Du C, Chen F
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-02-01
• Series: Therapeutics and Clinical Risk Management
• Subjects: Lung cancer; minimally invasive lung resection; postoperative pneumonia; postoperative pulmonary complications; risk factors.
• Online Access: https://www.dovepress.com/risk-factors-of-postoperative-pulmonary-complications-after-minimally--peer-reviewed-article-TCRM

Rong Yang,1 Yihe Wu,2,3 Linpeng Yao,1 Jinming Xu,2 Siying Zhang,1 Chengli Du,2 Feng Chen1 1Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China; 2Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China; 3Department of Thoracic Surgery, The First Division Hospital of Xinjiang Corps, Aksu City 843000, Xinjiang Autonomous Region, China Purpose: This study investigated the perioperative risk factors of postoperative pulmonary complications (PPCs) after minimally invasive anatomic resection for lung cancer.Patients and methods: We retrospectively reviewed the data from medical records of 729 lung cancer patients undergoing minimally invasive anatomic lung resections between January 2017 and December 2017. Univariate and binary logistic regression analyses were performed to select the independent risk factors for PPCs during the patient’s postoperative hospitalization after surgery.Results: The incidence of PPCs was 24.8% (n=181/729). No patient died during the period of hospitalization. Logistic regression analysis revealed that body mass index (BMI) $24.0 kg/m2 (vs <24.0 kg/m2: OR 1.514, 95% CI 1.057–2.167, P=0.024), single segmentectomy (vs single lobectomy: OR 2.115, 95% CI 1.150–3.891, P=0.016), bilobectomy or combined lobectomy and segmentectomy (vs single lobectomy: OR 2.731, 95% CI 1.013–7.361, P=0.047), and right lung lobe surgery (vs left lung lobe surgery: OR 1.519, 95% CI 1.046–2.205, P=0.028) were independent risk factors for PPCs in lung cancer patients who received minimally invasive anatomic lung resections. Conclusion: Individual factors such as BMI ≥24.0 kg/m2, single segmentectomy, bilobectomy or combined lobectomy and segmentectomy, and right lung lobe surgery were independent risk factors of PPCs, which should be helpful for risk stratification, patient counseling, and perioperative care for lung cancer patients. Keywords: lung cancer, minimally invasive lung resection, postoperative pneumonia, postoperative pulmonary complications, risk factors