Postoperative pulmonary complications following thoracic surgery during COVID-19 pandemic_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Maodan ¹ , NIU Lingli ² , WU Zhu ² , LIU Chengwu ² , ZHANG Xiaolong ² ,  WANG Wenping ²

1. Department of Thoracic Surgery, Shangjin Nanfu Hospital (Shangjin Branch of West China Hospital), Chengdu, 611743, P. R. China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

WANG Wenping, Email: drwangwp@163.com

Keywords：

Thoracic surgery; postoperative complications; fever; pulmonary complications; COVID-19 pneumonia

DOI：

10.7507/1007-4848.202102014

Video：

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Objective To explore the treatment strategies for patients with fever and pulmonary complications after thoracic surgery during COVID-19 epidemic.Methods The clinical data of 537 patients who ungerwent selective surgery at the Department of Thoracic Surgery, Shangjin Branch of West China Hospital between February and December 2020 were retrospectively analyzed, including 242 (45.1%) males and 295 (54.9%) females aged 53.3±13.4 years. We have established a procedure for the patients with fever and pulmonary complications after thoracic surgery to investigate the cause of the disease and track risk factors.Results The overall postoperative complication rate was 16.4% (88/537), and 1 (0.2%) patient died. Of 537 patients, 179 (33.3%) patients were enrolled in our model according to the inclusion criteria: ratio of males [112 (62.6%) vs. 130 (36.3%), P<0.010], patients with a history of smoking [74 (41.3%) vs. 87 (24.3%), P<0.010], or with esophageal cancer surgery [36 (20.1%) vs. 15 (4.2%)], or with traditional thoracotomy [14 (7.8%) vs. 4 (1.1%)] was higher than that of the other patients. Patients in our process due to fever or pulmonary complications had longer ICU stay and postoperative hospital stay (P=0.010). Logistic regression multivariate analysis showed that gender was an independent risk factor for postoperative fever or pulmonary complications.Conclusion In low-risk areas of the epidemic, the treatment process is simple and feasible, and the cause traceability and corresponding treatment can basically be completed within 24 hours. At the same time, the treatment process has been running stably for a long time.

Citation： YANG Maodan, NIU Lingli, WU Zhu, LIU Chengwu, ZHANG Xiaolong, WANG Wenping. Postoperative pulmonary complications following thoracic surgery during COVID-19 pandemic. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(8): 1024-1030. doi: 10.7507/1007-4848.202102014 Copy

1.	Jheon S, Ahmed AD, Fang VW, et al. Thoracic cancer surgery during the COVID-19 pandemic: A consensus statement from the Thoracic Domain of the Asian Society for Cardiovascular and Thoracic Surgery. Asian Cardiovasc Thorac Ann, 2020, 28(6): 322-329.
2.	戴富强, 郭伟, 邓波, 等. 新型冠状病毒肺炎非疫区胸外科临床工作建议. 中华外科杂志, 2020, 58(4): 273-277.
3.	Salmerón Jiménez M, Hermoso Alarza F, Martínez Serna I, et al. Clinical features and outcomes of thoracic surgery patients during the COVID-19 pandemic. Eur J Cardiothorac Surg, 2020, 58(4): 738-744.
4.	Bédat B, Abdelnour-Berchtold E, Perneger T, et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: A multicenter study. J Cardiothorac Surg, 2019, 14(1): 189.
5.	Raymond D. Complications of esophagectomy. Surg Clin North Am, 2012, 92(5): 1299-1313.
6.	Liang WH, Guan WJ, Li CC, et al. Clinical characteristics and outcomes of hospitalised patients with COVID-19 treated in Hubei (epicentre) and outside Hubei (non-epicentre): A nationwide analysis of China. Eur Respir J, 2020, 55(6): 2000562.
7.	沈小康, 任杰, 江文洋, 等. 17 例手术后感染新型冠状病毒肺炎病例临床分析. 武汉大学学报(医学版), 2021, 42(2): 245-249.
8.	刘焱斌, 刘涛, 崔跃, 等. 鼻拭子与咽拭子两种取样方法在新型冠状病毒肺炎核酸筛检中的比较研究. 中国呼吸与危重监护杂志, 2020, 19(2): 141-143.
9.	Brindle ME, Gawande A. Managing COVID-19 in surgical systems. Ann Surg, 2020, 272(1): e1-e2.
10.	Coimbra R, Edwards S, Kurihara H, et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg, 2020, 46(3): 505-510.
11.	Chakrabarti A, Bandyopadhyay M. Understanding the practice of thoracic surgery during the COVID-19 pandemic. Indian J Thorac Cardiovasc Surg, 2020, 36(5): 1-5.
12.	Thornton M, Reid D, Shelley B, et al. Management of the airway and lung isolation for thoracic surgery during the COVID-19 pandemic: Recommendations for clinical practice endorsed by the Association for Cardiothoracic Anaesthesia and Critical Care and the Society for Cardiothoracic Surgery in Great Britain and Ireland. Anaesthesia, 2020, 75(11): 1509-1516.
13.	徐燕, 刘洪生, 胡克, 等. 新型冠状病毒肺炎疫情期间肺癌患者临床管理. 中国肺癌杂志, 2020, 23(3): 136-141.
14.	Arolfo S, Velluti F, Romagnoli R, et al. COVID-19 outbreak and the practice of surgery: Do we need to change? Br J Surg, 2020, 107(9): e307-e308.
15.	Li YX, He CZ, Liu YC, et al. The impact of COVID-19 on gastric cancer surgery: A single-center retrospective study. BMC Surg, 2020, 20(1): 222.
16.	Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine, 2020, 21: 100331.
17.	Li YK, Peng S, Li LQ, et al. Clinical and transmission characteristics of Covid-19—A retrospective study of 25 cases from a single thoracic surgery department. Curr Med Sci, 2020, 40(2): 295-300.
18.	COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. Lancet, 2020, 396(10243): 27-38.
19.	Doglietto F, Vezzoli M, Gheza F, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surg, 2020, 155(8): 691-702.
20.	Al-Balas M, Al-Balas HI, Al-Balas H. Surgery during the COVID-19 pandemic: A comprehensive overview and perioperative care. Am J Surg, 2020, 219(6): 903-906.
21.	谢冬, 王思桦, 姜格宁, 等. 新型冠状病毒肺炎疫情下胸外科面临的挑战与对策. 中国胸心血管外科临床杂志, 2020, 27(4): 359-363.
22.	韩鹏, 付向宁, 曹鹏, 等. 肺癌围手术期合并新型冠状病毒肺炎一例. 中国胸心血管外科临床杂志, 2020, 27(4): 381-384.
23.	成都市卫生健康委员会. 成都 12 月 7 日新增境外输入确诊病例 3 例, 本土确诊病例 2 例. 2020. URL: http://cdwjw.chengdu.gov.cn/cdwjw/gzdt/2020-12/08/content_87af197b1cd54d628d1d4e1ce199f8ac.shtml.

1. Jheon S, Ahmed AD, Fang VW, et al. Thoracic cancer surgery during the COVID-19 pandemic: A consensus statement from the Thoracic Domain of the Asian Society for Cardiovascular and Thoracic Surgery. Asian Cardiovasc Thorac Ann, 2020, 28(6): 322-329.
2. 戴富强, 郭伟, 邓波, 等. 新型冠状病毒肺炎非疫区胸外科临床工作建议. 中华外科杂志, 2020, 58(4): 273-277.
3. Salmerón Jiménez M, Hermoso Alarza F, Martínez Serna I, et al. Clinical features and outcomes of thoracic surgery patients during the COVID-19 pandemic. Eur J Cardiothorac Surg, 2020, 58(4): 738-744.
4. Bédat B, Abdelnour-Berchtold E, Perneger T, et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: A multicenter study. J Cardiothorac Surg, 2019, 14(1): 189.
5. Raymond D. Complications of esophagectomy. Surg Clin North Am, 2012, 92(5): 1299-1313.
6. Liang WH, Guan WJ, Li CC, et al. Clinical characteristics and outcomes of hospitalised patients with COVID-19 treated in Hubei (epicentre) and outside Hubei (non-epicentre): A nationwide analysis of China. Eur Respir J, 2020, 55(6): 2000562.
7. 沈小康, 任杰, 江文洋, 等. 17 例手术后感染新型冠状病毒肺炎病例临床分析. 武汉大学学报(医学版), 2021, 42(2): 245-249.
8. 刘焱斌, 刘涛, 崔跃, 等. 鼻拭子与咽拭子两种取样方法在新型冠状病毒肺炎核酸筛检中的比较研究. 中国呼吸与危重监护杂志, 2020, 19(2): 141-143.
9. Brindle ME, Gawande A. Managing COVID-19 in surgical systems. Ann Surg, 2020, 272(1): e1-e2.
10. Coimbra R, Edwards S, Kurihara H, et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg, 2020, 46(3): 505-510.
11. Chakrabarti A, Bandyopadhyay M. Understanding the practice of thoracic surgery during the COVID-19 pandemic. Indian J Thorac Cardiovasc Surg, 2020, 36(5): 1-5.
12. Thornton M, Reid D, Shelley B, et al. Management of the airway and lung isolation for thoracic surgery during the COVID-19 pandemic: Recommendations for clinical practice endorsed by the Association for Cardiothoracic Anaesthesia and Critical Care and the Society for Cardiothoracic Surgery in Great Britain and Ireland. Anaesthesia, 2020, 75(11): 1509-1516.
13. 徐燕, 刘洪生, 胡克, 等. 新型冠状病毒肺炎疫情期间肺癌患者临床管理. 中国肺癌杂志, 2020, 23(3): 136-141.
14. Arolfo S, Velluti F, Romagnoli R, et al. COVID-19 outbreak and the practice of surgery: Do we need to change? Br J Surg, 2020, 107(9): e307-e308.
15. Li YX, He CZ, Liu YC, et al. The impact of COVID-19 on gastric cancer surgery: A single-center retrospective study. BMC Surg, 2020, 20(1): 222.
16. Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine, 2020, 21: 100331.
17. Li YK, Peng S, Li LQ, et al. Clinical and transmission characteristics of Covid-19—A retrospective study of 25 cases from a single thoracic surgery department. Curr Med Sci, 2020, 40(2): 295-300.
18. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. Lancet, 2020, 396(10243): 27-38.
19. Doglietto F, Vezzoli M, Gheza F, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surg, 2020, 155(8): 691-702.
20. Al-Balas M, Al-Balas HI, Al-Balas H. Surgery during the COVID-19 pandemic: A comprehensive overview and perioperative care. Am J Surg, 2020, 219(6): 903-906.
21. 谢冬, 王思桦, 姜格宁, 等. 新型冠状病毒肺炎疫情下胸外科面临的挑战与对策. 中国胸心血管外科临床杂志, 2020, 27(4): 359-363.
22. 韩鹏, 付向宁, 曹鹏, 等. 肺癌围手术期合并新型冠状病毒肺炎一例. 中国胸心血管外科临床杂志, 2020, 27(4): 381-384.
23. 成都市卫生健康委员会. 成都 12 月 7 日新增境外输入确诊病例 3 例, 本土确诊病例 2 例. 2020. URL: http://cdwjw.chengdu.gov.cn/cdwjw/gzdt/2020-12/08/content_87af197b1cd54d628d1d4e1ce199f8ac.shtml.

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