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首页> 外文期刊>Journal of Cardiothoracic Surgery >Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study
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Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study

机译：电视胸腔镜手术在部分切除术和肺叶切除术术后并发症的比较：多中心研究

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Abstract BackgroundCompared to lobectomy by video-assisted thoracic surgery (VATS), segmentectomy by VATS has a potential higher risk of postoperative atelectasis and air leakage. We compared postoperative complications between these two procedures, and analyzed their risk factors.MethodsWe reviewed the records of all patients who underwent anatomical pulmonary resections by VATS from January 2014 to March 2018 in two Swiss university hospitals. All complications were reported. A logistic regression model was used to compare the risks of complications for the two interventions. Adjustment for patient characteristics was performed using a propensity score, and by including risk factors separately.ResultsAmong 690 patients reviewed, the major indication for lung resection was primary lung cancer (86.4%) followed by metastasis resection (5.8%), benign lesion (3.9%), infection (3.2%) and emphysema (0.7%). Postoperatively, there were 80 instances (33.3%) of complications in 240 segmentectomies, and 171 instances (38.0%) of complications in 450 lobectomies ( P =?0.73). After adjustment for the patient’s propensity to be treated by segmentectomy rather than lobectomy, the risks of a complication remained comparable for the two techniques (odds ratio for segmentectomy 0.91 (0.61–1.30), p =?0.59). Length of hospital stay and drainage duration were shorter after segmentectomy. On multivariate analysis, an American Society of Anesthesiologists score above 2 and a forced expiratory volume in one second below 80% of predicted value were significantly associated with the occurrence of complications.ConclusionsThe rate of complications and their grade were similar between segmentectomy and lobectomy by VATS.
机译：摘要背景与电视胸腔镜切除术（VATS）相比，VATS肺段切除术具有更高的术后肺不张和漏气的风险。我们比较了这两种方法之间的术后并发症，并分析了它们的危险因素。方法我们回顾了2014年1月至2018年3月在瑞士的两家大学医院中通过VATS进行了解剖肺切除的所有患者的记录。报道了所有并发症。使用逻辑回归模型比较两种干预措施的并发症风险。结果：在690例患者中，肺切除的主要适应症是原发性肺癌（86.4％），然后是转移性切除（5.8％），良性病变（3.9）。 ％），感染（3.2％）和肺气肿（0.7％）。术后240例节段切除术中有80例发生并发症（33.3％），而450例肺段切除术中有171例发生并发症（38.0％）（P =？0.73）。调整患者通过节段切除术而不是肺叶切除术治疗的倾向后，两种技术的并发症风险仍然相当（节段切除术的比值比为0.91（0.61-1.30），p =？0.59）。节段切除术后住院时间短，引流时间短。在多变量分析中，美国麻醉医师学会评分高于2且一秒内呼气量低于预期值的80％与并发症的发生率显着相关。结论VATS肺段切除术和肺叶切除术的并发症发生率及其等级相似。

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