Evaluation of Risk Factors for Early Insufficiency after Bronchial Sleeve Resections.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Thoracic and Cardiovascular Surgeon Pub Date : 2024-08-29 DOI:10.1055/a-2382-8087
Evgeny Levchenko, Viktoriia Shabinskaya, Nikita Levchenko, Alexander Mikhnin, Oleg Mamontov, Stepan Ergnyan
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Abstract

Background:  Bronchoplastic resections are now widely used as a surgical treatment for resectable central lung cancer. However, bronchial dehiscence is one of the most life-threatening complications, making it important to identify its risk factors to separate patients who require more attention during the postoperative period.

Methods:  The data of 285 patients who underwent bronchoplasty from 2006 to 2021 were retrospectively reviewed. We collected demographic characteristics, history of neoadjuvant therapy, preoperative assessment, perioperative outcomes, and postoperative complications to investigate different variables as risk factors for bronchial dehiscence by univariate and multivariate analyses.

Results:  Bronchial dehiscence was diagnosed in 12 patients (4.2%) with a mean presentation on postoperative day 10 (range: 1-24 days). By multivariate analysis, current smoking (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.1-20.1, p = 0.032), chronic obstructive pulmonary disease (COPD; OR: 6.5, 95% CI: 1.2-33.8, p = 0.027), bronchoplastic right lower lobectomy (OR: 12.9, 95% CI: 2.4-69.7, p = 0.003), and upper sleeve bilobectomy with segmentectomy S6 by performing an anastomosis between right main bronchus (RMB) and bronchus of basal pyramid (BP) (OR: 30.4, 95% CI: 3.4-268.1, p = 0.002) were confirmed as relevant risk factors for developing bronchial dehiscence.

Conclusion:  Current smoking, COPD, bronchoplastic right lower lobe, and upper l with segmentectomy S6 by performing an anastomosis between RMB and bronchus of BP were identified with the occurrence of bronchial dehiscence after sleeve resection.

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评估支气管袖状切除术后早期功能不全的风险因素。
背景:目前,支气管整形切除术已被广泛应用于可切除中央型肺癌的手术治疗。然而,支气管裂开是最危及生命的并发症之一,因此确定其风险因素以区分术后需要更多关注的患者非常重要:方法:我们对 2006 年至 2021 年期间接受支气管成形术的 285 名患者的数据进行了回顾性分析。我们收集了人口统计学特征、新辅助治疗史、术前评估、围术期结果和术后并发症,通过单变量和多变量分析研究支气管开裂的风险因素:12名患者(4.2%)被诊断为支气管裂开,平均发病时间为术后第10天(范围:1-24天)。通过多变量分析发现,目前吸烟(几率比(OR):4.8,95% 置信区间(OR:4.8,95% 置信区间(CI):1.1-20.1,p = 0.032)、慢性阻塞性肺病(OR:6.5,95% CI:1.2-33.8,p = 0.027)、支气管整形右下叶切除术(OR:12.9,95% CI:2.4-69.7,p = 0.003),以及通过在右主支气管和基底金字塔支气管之间进行吻合的上袖状双叶切除术和S6段切除术(OR:30.4,95% CI:3.4-268.1,p = 0.002)被证实为发生支气管裂开的相关危险因素:结论:目前吸烟、慢性阻塞性肺病、支气管成形术 RLL 和上双叶切除术 S6 段切除术(在 RMB 和 BP 支气管之间进行吻合)与袖状切除术后支气管开裂的发生有关。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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