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- Title
胸膜腔黏连对非小细胞肺癌患者行胸腔镜下肺叶切除术的影响分析.
- Authors
范晓东; 陈召; 陈静; 卢强; 张继朋; 王武平; 李哲
- Abstract
Objective: To analyze the effect of pleural adhesion on the thoracoscopic lobectomy in patients with non-small cell lung cancer, and explore the influencing factors of postoperative complications after thoracoscopic lobectomy. Methods:Patients with non-small cell lung cancer who underwent thoracoscopic lobectomy in our department from January 2014 to December 2017 were collected. The basic data of patients were collected by searching electronic medical records and telephone follow-up, including gender, age, BMI index, Percentage predicted forced expiratory volume in 1 s (FEV1%), American Society of Anesthesiologists (ASA), postoperative pathological findings, and preoperative complications. The patient's surgery-related conditions were collected, including pleural adhesion, operative time, intraoperative bleeding, intraoperative conversion, postoperative drainage, length of hospital stay, complications, and 30-day postoperative death. Patients were divided into two groups according to whether they had pleural adhesion or not. The basic information and postoperative conditions of the two groups were compared and analyzed. The effects of pleural adhesion on intraoperative and postoperative results were observed. In addition, the patients were divided into two groups according to whether they had postoperative complications or not. The indexes of two groups were comparatively analyzed. Logistic regression analysis was performed to investigate the risk factors for postoperative complications. Results: According to the inclusion and exclusion criteria, a total of 447 patients were included in the study and 142 patients had pleural adhesion. The operative time, intraoperative bleeding, conversion to thoracotomy, drainage at two days after surgery, drainage time, postoperative hospital stay, and postoperative complications of patients with pleural adhesion were higher than those of patients without pleural adhesion (P<0.05). The age, female proportion, smoking number, preoperative respiratory complications, pleural adhesion, ASA score, and operation time of patients with postoperative complications were higher than those without postoperative complications (P<0.05). Pleural adhesion (OR=4.185, P=0.020), ASA scores (OR=1.143, P=0.001), smoking (OR=3.329, P=0.005), extended operative time (OR=1.623, P=0.038) and preoperative respiratory complications (OR=2.713, P=0.027) were independent risk factors for the postoperative complications. Conclusions: Pleural adhesion increases the difficulty of thoracoscopic lobectomy in patients with non-small cell lung cancer, intraoperative conversion, and risk of postoperative complications.
- Subjects
AMERICAN Society of Anesthesiologists; THORACOTOMY; NON-small-cell lung carcinoma; SURGICAL complications; LOGISTIC regression analysis; ELECTRONIC health records; AMBULATORY surgery
- Publication
Progress in Modern Biomedicine, 2019, Vol 19, Issue 5, p928
- ISSN
1673-6273
- Publication type
Article
- DOI
10.13241/j.cnki.pmb.2019.05.030