Prophylactic fiberoptic bronchoscopy after sleeve lobectomy can reduce the incidence of postoperative pneumonia: a propensity score matching study.

Abstract

Background: Postoperative pneumonia (POP) predicts poor outcomes after lung surgery, especially for patients undergoing sleeve lobectomy. Fiberoptic bronchoscopy (FOB) is frequently used in the treatment of POP for patients receiving sleeve lobectomy. This study aimed to assess the effect of prophylactic FOB on the incidence of POP in these patients.

Methods: This is a single-center retrospective cohort study. Postoperative outcomes of patients who underwent sleeve lobectomy for central lung cancer from August 2005 to August 2020 in the West China Hospital were collected. The included patients were divided into two groups based on whether prophylactic FOB was performed, and the two groups were compared using propensity score matching (PSM).

Results: A total of 314 patients were included in this study. There were 166 patients in the aspirated group and 148 patients in the non-aspirated group. PSM resulted in 133 patients in each group. The aspirated group was associated with a lower incidence of POP (7.5% vs. 17.3%; P=0.03), shorter duration of antibiotic use (5.6±3.3 vs. 6.9±3.9 days; P=0.003), and shorter postoperative hospital stay (9.3±4.8 vs. 10.7±5.5 days; P=0.04).

Conclusions: Prophylactic FOB after sleeve lobectomy was associated with improved postoperative outcomes and might be recommended for patients undergoing sleeve lobectomy.