|Table of Contents|

Postoperative complications of video-assisted thoracoscopic surgery for non-small cell lung cancer and its impact on prognosis

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 05
Page:
857-862
Research Field:
Publishing date:

Info

Title:
Postoperative complications of video-assisted thoracoscopic surgery for non-small cell lung cancer and its impact on prognosis
Author(s):
SU Peng; TIAN Ziqiang; XU Yanzhao; LYU Huilai; LI Zhenhua; WEN Shiwang
The Fifth Department of Thoracic Surgery,Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050011,China.
Keywords:
non-small cell lung cancer; thoracoscopy; complications; diabetes; prognosis
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2024.05.013
Abstract:
Objective:To investigate the postoperative complications of non-small cell lung cancer patients underwent video-assisted thoracoscopic surgery and its impact on the prognosis of patients.Methods:A total of 102 patients with non-small cell lung cancer who underwent video-assisted thoracoscopic surgery in our hospital from June 2017 to June 2020 were randomly selected as the study subjects.The clinical and follow-up data were collected and analyzed.Logistic regression analysis explored the risk factors affecting postoperative complications or severe complications.Survival analysis was performed with relapse as the endpoint and the differences in relapse free survival among different groups of patients were compared.Results:Among the 102 patients included,we found that the patient's age(OR=4.009，95%CI:1.209~13.299，P=0.023),diabetes(OR=3.515，95%CI:1.045~11.819，P=0.042),operation time(OR=1.014，95%CI:1.002~1.026，P=0.020),and intraoperative blood loss(OR=1.016，95%CI:1.008~1.025,P＜0.001) were influencing factors for postoperative complications.At the same time,operation time(OR=1.123，95%CI:1.008~1.252，P=0.036) were the influencing factors for severe postoperative complications.The postoperative hospital stay in the complication group was significantly longer than that in the non-complication group(P＜0.001).The relapse-free survival rate of patients without complications were significantly higher than that of patients with complications(HR=1.43，95%CI:1.03~1.99，P=0.033).The relapse-free survival rate of patients without severe complications were significantly higher than that of patients with severe complications(HR=1.61，95%CI:1.15~2.24，P=0.005).Conclusion:For patients with non-small cell lung cancer underwent video-assisted thoracoscopic surgery,age,diabetes,operation time,and intraoperative blood loss were independent influencing factors of postoperative complications,and postoperative complications can significantly reduce the relapse-free survival of patients.

References:

［1］SUNG H,FERLAY J,SIEGEL RL,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2021,71(3):209-249.
［2］ZHENG RS,ZHANG SW,ZENG HM,et al.Cancer incidence and mortality in China,2016［J］.Journal of the National Cancer Center,2022,2(1):1-9.
［3］PADINHARAYIL H,VARGHESE J,JOHN MC,et al.Non-small cell lung carcinoma(NSCLC):Implications on molecular pathology and advances in early diagnostics and therapeutics［J］.Genes Dis,2023,10(3):960-989.
［4］LIU S,LI S,TANG Y,et al.Minimally invasive surgery vs.open thoracotomy for non-small-cell lung cancer with N2 disease:A systematic review and Meta-analysis［J］.Front Med(Lausanne),2023,10:1152421.
［5］WALKER WS,CARNOCHAN FM,PUGH GC.Thoracoscopic pulmonary lobectomy.Early operative experience and preliminary clinical results［J］.J Thorac Cardiovasc Surg,1993,106(6):1111-1117.
［6］谢博恒,隋天一,秦毅,等.机器人辅助与电视辅助胸腔镜肺段切除术治疗早期非小细胞肺癌短期效果比较［J］.中国肺癌杂志,2019,22(12):767-771. XIE BH,SUI TY,QIN Y,et al.Comparison of short-term outcomes of lung segmentectomy by robotic-assisted and video-assisted thoracoscopic surgery［J］.Chin J Lung Cancer,2019,22(12):767-771.
［7］JAWITZ OK,WANG Z,BOFFA DJ,et al.The differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies［J］.Eur J Cardiothorac Surg,2017,51(1):169-174.
［8］MATHISEN DJ.Re:Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer:A propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database［J］.Eur J Cardiothorac Surg,2016,49(2):609-610.
［9］GHALY G,KAMEL M,NASAR A,et al.Video-assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stage I non-small cell lung cancer［J］.Ann Thorac Surg,2016,101(2):465-472.
［10］TSUBOKAWA N,HARADA H,TAKENAKA C,et al.Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical stimulation［J］.Thorac Cardiovasc Surg,2015,63(6):519-525.
［11］曾敏，徐利强.单孔胸腔镜下肺段切除术治疗非小细胞肺癌的疗效观察［J］.现代肿瘤医学，2020,28(20):3560－3564. ZENG M,XU LQ.Observation of curative effect of single-hole thoracoscopic segmentectomy for non-small cell lung cancer［J］.Modern Oncology,2020,28(20):3560－3564.
［12］MAHIEU J,RINIERI P,BUBENHEIM M,et al.Robot-assisted thoracoscopic surgery versus video-assisted thoracoscopic surgery for lung lobectomy:Can a robotic approach improve short-term outcomes and operative safety［J］.Thorac Cardiovasc Surg,2016,64(4):354-362.
［13］MERRITT RE,KNEUERTZ PJ,D'SOUZA DM.Successful transition to robotic-assisted lobectomy with previous proficiency in thoracoscopic lobectomy［J］.Innovations(Phila),2019,14(3):263-271.
［14］HUANG J,TIAN Y,ZHOU QJ，et al.Comparison of perioperative outcomes of robotic-assisted versus video-assisted thoracoscopic right upper lobectomy in non-small cell lung cancer［J］.Transl Lung Cancer Res,2021,10(12):4549-4557.
［15］ZHOU Q,HUANG J,PAN F，et al.Operative outcomes and long-term survival of robotic-assisted segmentectomy for stage Ⅰa lung cancer compared with video-assisted thoracoscopic segmentectomy［J］.Transl Lung Cancer Res,2020,9(2):306-315.
［16］AGOSTINI P,CIESLIK H,RATHINAM S,et al.Postoperative pulmonary complications following thoracic surgery:Are there any modifiable risk factors［J］.Thorax,2010,65(9):815-818.
［17］STEPHAN F,BOUCHESEICHE S,HOLLANDE J,et al.Pulmonary complications following lung resection:A comprehensive analysis of incidence and possible risk factors［J］.Chest,2000,118(5):1263-1270.
［18］CAO C,MANGANAS C,ANG SC,et al.A Meta-analysis of unmatched and matched patients comparing video-assisted thoracoscopic lobectomy and conventional open lobectomy［J］.Ann Cardiothorac Surg,2012,1(1):16-23.
［19］CHEN K,WANG X,YANG F,et al.Propensity-matched comparison of video-assisted thoracoscopic with thoracotomy lobectomy for locally advanced non-small cell lung cancer［J］.J Thorac Cardiovasc Surg,2017,153(4):967-976 e962.
［20］DELL'AMORE A,LOMANGINO I,TAMBURINI N,et al.Video-assisted thoracoscopic lobectomy after neoadjuvant chemotherapy for non-small cell lung cancer:A multicenter propensity-matched study［J］.Surg Endosc,2022,36(2):1466-1475.
［21］RUETH NM,PARSONS HM,HABERMANN EB,et al.The long-term impact of surgical complications after resection of stage Ⅰ non-small cell lung cancer:A population-based survival analysis［J］.Ann Surg,2011,254(2):368-374.
［22］GUO F,MA D,LI S.Compare the prognosis of Da Vinci robot-assisted thoracic surgery(RATS) with video-assisted thoracic surgery(VATS) for non-small cell lung cancer:A Meta-analysis［J］.Medicine(Baltimore),2019,98(39):e17089.
［23］JIN R,ZHENG Y,YUAN Y,et al.Robotic-assisted versus video-assisted thoracoscopic lobectomy:Short-term results of a randomized clinical trial(RVlob Trial)［J］.Ann Surg,2022,275(2):295-302.
［24］ZHANG C,MA Y,YU Z,et al.Comparison of efficacy and safety of hybrid video-assisted thoracoscopic surgery vs.thoracotomy sleeve lobectomy for non-small cell lung cancer:A propensity score matching study［J］.J Thorac Dis,2022,14(7):2635-2644.
［25］LYSSENKO V,VAAG A.Genetics of diabetes-associated microvascular complications［J］.Diabetologia,2023,66(9):1601-1613.
［26］ZHANG H,CHEN Y,ZHU W,et al.The mediating role of HbA1c in the association between elevated low-density lipoprotein cholesterol levels and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus［J］.Lipids Health Dis,2023,22(1):102.
［27］MARXEN T,SU S,BROWN C,et al.Preoperative glucose predicts postoperative complications after complex abdominal wall reconstruction［J］.Ann Plast Surg,2023,91(1):124-128.
［28］AL ZAIDI M,WRIGHT GM,YASUFUKU K.Suggested robotic-assisted thoracic surgery training curriculum［J］.J Thorac Dis,2023,15(2):791-798.
［29］LUGG ST,AGOSTINI PJ,TIKKA T,et al.Long-term impact of developing a postoperative pulmonary complication after lung surgery［J］.Thorax,2016,71(2):171-176.
［30］SHINOHARA S,KOBAYASHI K,KASAHARA C,et al.Long-term impact of complications after lung resections in non-small cell lung cancer［J］.J Thorac Dis,2019,11(5):2024-2033.
［31］王少东，隋锡朝,李晓,等.胸腔镜肺癌根治术后肺部并发症对远期预后的影响［J］.中华胸心血管外科杂志,2018,34(1):1-5. WANG SD,SUI XC,LI X,et al.The long-term impact of postoperative pulmonary complication after resection of non-small cell lung cancer［J］.Chin J Thoracand Cardiovasc Surg,2018,34(1):1-5.

Memo

Memo:
河北省医学科学研究课题计划（编号：20221223）
Last Update: 2024-01-30