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首页> 外文期刊>Journal of Thoracic Disease >Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience
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Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience

机译：电视胸腔镜手术治疗肺段切除术后并发症的临床结果和危险因素：初步经验的结果

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Background: Pulmonary anatomical segmentectomies are increasingly being done via video-assisted thoracoscopic surgery (VATS). We analyzed clinical outcomes and risk factors for post-operative complications after pulmonary segmentectomy by VATS was introduced in two institutions. Methods: We retrospectively reviewed records of all patients who underwent anatomical pulmonary segmentectomy by VATS from 2014 to 2016 at the university hospitals of Geneva and Lausanne in Switzerland. Results: One hundred twenty-nine patients (64 men; median age 68 years, range, 29–85 years) underwent anatomical VATS segmentectomy for primary lung tumors (n=100), metastases (n=16) and benign lesions (n=13). The overall 30-day mortality and morbidity rates were 0.8% and 31%, respectively. The reoperation rate was 4.7% [indications: hemothorax 2, prolonged air leak (PAL) 2, segmental torsion 1, empyema 1]. Chest drainage lasted for a median of 2 days (range, 1–33 days) and patients were discharged from the hospital after a median of 6 days (range, 2–37 days). Postoperative complications were mainly associated with chronic obstructive pulmonary disease (COPD) [odds ratio (OR) 2.54 and 95% confidence interval (95% CI), 1.18–5.47], and smoking pack-years 50 units (OR 5.27; 95% CI, 1.68–16.55). Nine patients (9%) presented with distant recurrences. Nodule size 2 cm was associated with decreased disease-free survival (DFS) (P=0.04). There was no association between surgical experience in VATS segmentectomy and DFS or postoperative complications. Conclusions: Segmentectomies can be safely performed by VATS in an initial experience and result in favorable clinical outcome. COPD and smoking pack-years are associated with an increased risk of complications.
机译：背景：肺部解剖节段越来越多地通过电视胸腔镜手术（VATS）进行。我们分析了在两个机构中采用VATS进行肺段切除术后的临床结果和术后并发症的危险因素。方法：我们回顾性回顾了2014年至2016年间在瑞士日内瓦大学医院和瑞士洛桑大学医院接受VATS解剖肺段切除术的所有患者的记录。结果：129例患者（64名男性，中位年龄68岁，范围29-85岁）接受了原位肺肿瘤（n = 100），转移（n = 16）和良性病变（n = 13）。 30天的总死亡率和发病率分别为0.8％和31％。再次手术率为4.7％[适应症：血胸2，长时间漏气（PAL）2，节段性扭转1，脓胸1]。胸腔引流持续了中位数2天（范围1–33天），患者在中位数6天（范围2–37天）后出院。术后并发症主要与慢性阻塞性肺疾病（COPD）[比值比（OR）2.54和95％置信区间（95％CI），1.18–5.47]和吸烟包年> 50单位有关（OR 5.27; 95％ CI，1.68–16.55）。 9例患者（9％）表现为远处复发。结节大小> 2 cm与无病生存期降低（DFS）相关（P = 0.04）。 VATS段切除术的手术经验与DFS或术后并发症之间没有关联。结论：VATS可以在最初的经验中安全地进行节段切除术，并取得良好的临床效果。 COPD和吸烟年数与并发症风险增加有关。

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