Risk factors for postoperative complications Clavien-Dindo classification≥gradeⅡ after lung cancer surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIAO Xiaoqing ¹ ,  CHEN Zhang ¹ ,  DAI Wei ² , WEI Xing ² , PU Yang ³ , LIN Chao ¹ , FENG Wenhong ⁴ , ZHANG Yuanqiang ⁵ , MU Yunfei ⁶ , ZHANG Rui ⁷ , XIE Shaohua ² , WANG Xin ² , SHI Qiuling ^3,8 , LI Qiang ²

1. Department of Cardiothoracic Surgery, Dazhu County People's Hospital, Dazhou, 635100, Sichuan, P. R. China;
2. Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, 610041, P. R. China;
3. School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, P. R. China;
4. Department of Thoracic and Cardiovascular Surgery, Jiangyou People's Hospital, 621700, Sichuan, P. R. China;
5. Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, 643000, Sichuan, P. R. China;
6. Department of Thoracic Surgery, The Third People's Hospital of Chengdu, Chengdu, 610031, P. R. China;
7. Department of Thoracic Surgery, The Seventh People's Hospital of Chengdu, Chengdu, 610021, P. R. China;
8. Center for Cancer Prevention Research, Sichuan Cancer Hospital, Chengdu, 610041, P. R. China;

Corresponding author：

CHEN Zhang, Email: 27418538@qq.com; DAI Wei, Email: daiwei@sichuancancer.org

Keywords：

Lung cancer; surgery; complications; Clavien-Dindo classification; risk factor

DOI：

10.7507/1007-4848.202111049

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the risk factors for postoperative complications Clavien-Dindo classification≥grade Ⅱ after lung cancer surgery. Methods The patients who underwent lung cancer surgery in a multicenter observational study from November 2017 to January 2020 were included. The Clavien-Dindo classification of postoperative complications was analyzed. Logistic regression was used to identify the risk factors for complications≥ gradeⅡ. Results A total of 388 patients were enrolled, including 203 males and 185 females with a mean age of 56.14±10.36 years. The incidence of postoperative complications was 25.52% (99/388) after lung cancer surgery and the incidence of complications≥gradeⅡ was 20.10% (78/388). The five most common postoperative complications were pneumonia (6.96%), prolonged pulmonary air leak (>7 days, 5.67%), incision dehiscence (4.64%), arrhythmia (3.87%), and postoperative pleural effusion (3.35%). Multivariate analysis showed that open surgery [reference: uniportal thoracoscopic surgery, OR=2.18, 95%CI (1.01, 4.70), P=0.047], extended resection [reference: sublobar resection, OR=2.86, 95%CI (1.11, 7.19), P=0.030; reference: lobectomy, OR=2.20, 95%CI (1.10, 4.40), P=0.026] and operative time≥3 h [OR=2.07, 95%CI (1.12, 3.85), P=0.021] were independent risk factors for postoperative complications≥gradeⅡ after lung cancer surgery. Conclusion Surgical approach, extent of resection and operative time are independent influencing factors for postoperative complications≥gradeⅡ after lung cancer surgery.

Citation： LIAO Xiaoqing, CHEN Zhang, DAI Wei, WEI Xing, PU Yang, LIN Chao, FENG Wenhong, ZHANG Yuanqiang, MU Yunfei, ZHANG Rui, XIE Shaohua, WANG Xin, SHI Qiuling, LI Qiang. Risk factors for postoperative complications Clavien-Dindo classification≥gradeⅡ after lung cancer surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(8): 1151-1157. doi: 10.7507/1007-4848.202111049 Copy

1.	Chen F, Wang G. Enhanced recovery after surgery for lung cancer patients. Open Med (Wars), 2020, 15: 198-203.
2.	李鹏飞, 赖玉田, 周坤, 等. 应用Clavien-Dindo分级系统对肺癌患者术后并发症分级及危险因素分析. 中国肺癌杂志, 2017, 20(4): 264-271.
3.	Fernandez FG, Falcoz PE, Kozower BD, et al. The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons general thoracic surgery databases: Joint standardization of variable definitions and terminology. Ann Thorac Surg, 2015, 99(1): 368-376.
4.	中国医师协会胸外科医师分会, 胸外科专业术语标准化委员会. 胸外科疾病标准化诊疗术语. 北京: 人民卫生出版社, 2017. 81-106.
5.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
6.	岑磊磊. 结肠癌根治术后并发症的Clavien-Dindo分级及其危险因素分析. 中国现代普通外科进展, 2021, 24(9): 706-710.
7.	王少东, 隋锡朝, 杨帆, 等. 早期非小细胞肺癌VATS根治术并发症预测模型的建立—前瞻性多中心研究. 中华胸心血管外科杂志, 2017, 33(2): 87-90, 102.
8.	王政. 非小细胞肺癌肺叶切除术后并发症分级及其危险因素分析. 蚌埠医学院, 2020.
9.	聂蕴韬. 改良POSSUM评分联合Clavien-Dindo分级预测胸腔镜肺手术术后严重并发症发生率的应用研究. 河北医科大学, 2018.
10.	Dai W, Xie S, Zhang R, et al. Developing and validating utility parameters to establish patient-reported outcome-based perioperative symptom management in patients with lung cancer: A multicentre, prospective, observational cohort study protocol. BMJ Open, 2019, 9(10): e030726.
11.	Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis, 1987, 40(5): 373-383.
12.	Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status—Historical perspectives and modern developments. Anaesthesia, 2019, 74(3): 373-379.
13.	Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
14.	Sawada S, Suehisa H, Ueno T, et al. Changes in post-operative complication and mortality rates after lung cancer resection in the 20-year period 1995-2014. Acta Med Okayama, 2016, 70(3): 183-188.
15.	夏琰, 倪铮铮, 杨洁, 等. 胸腔镜肺癌根治术术后并发症及其严重程度的危险因素分析. 中华胸心血管外科杂志, 2013, 29(8): 487-490.
16.	Motono N, Ishikawa M, Iwai S, et al. Individualization of risk factors for postoperative complication after lung cancer surgery: A retrospective study. BMC Surg, 2021, 21(1): 311.
17.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
18.	Dai W, Dai Z, Wei X, et al. Early patient-reported outcomes after uniportal vs. multiportal thoracoscopic lobectomy. Ann Thorac Surg, 2021, S0003-4975(21): 01674-X.
19.	Wei X, Yu H, Dai W, et al. Patient-reported outcomes of video-assisted thoracoscopic surgery versus thoracotomy for locally advanced lung cancer: A longitudinal cohort study. Ann Surg Oncol, 2021, 28(13): 8358-8371.
20.	Dimitrovska NT, Bao F, Yuan P, et al. Learning curve for two-port video-assisted thoracoscopic surgery lung segmentectomy. Interact Cardiovasc Thorac Surg, 2022, 34(3): 402-407.
21.	Migliore M, Criscione A, Calvo D, et al. Safety of video-assisted thoracic surgery lobectomy for non-small-cell lung cancer in a low-volume unit. Future Oncol, 2016, 12(23s): 47-50.
22.	冀华逊. 非小细胞肺癌术后并发症的危险因素分析. 转化医学电子杂志, 2015, 2(11): 68-69.
23.	Pennathur A, Brunelli A, Criner GJ, et al. Definition and assessment of high risk in patients considered for lobectomy for stage Ⅰ non-small cell lung cancer: The American Association for Thoracic Surgery expert panel consensus document. J Thorac Cardiovasc Surg, 2021, 162(6): 1605-1618.
24.	Lugg ST, Agostini PJ, Tikka T, et al. Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax, 2016, 71(2): 171-176.
25.	姜格宁, 张雷, 朱余明, 等. 肺切除手术患者术前肺功能评估肺科共识. 中国胸心血管外科临床杂志, 2020, 27(1): 1-9.
26.	Zhang Y, Jheon S, Li H, et al. Results of low-dose computed tomography as a regular health examination among Chinese hospital employees. J Thorac Cardiovasc Surg, 2020, 160(3): 824-831.
27.	孙大强, 陈平雁, 刘伦旭, 等. 11958例Ⅰ~ⅢA期非小细胞肺癌手术患者不同随访方式5年生存率比较的多中心真实世界研究. 中国胸心血管外科临床杂志, 2021, 28(6): 615-622.
28.	Pompili C, McLennan Battleday F, Chia WL, et al. Poor preoperative quality of life predicts prolonged hospital stay after VATS lobectomy for lung cancer. Eur J Cardiothorac Surg, 2021, 59(1): 116-121.

1. Chen F, Wang G. Enhanced recovery after surgery for lung cancer patients. Open Med (Wars), 2020, 15: 198-203.
2. 李鹏飞, 赖玉田, 周坤, 等. 应用Clavien-Dindo分级系统对肺癌患者术后并发症分级及危险因素分析. 中国肺癌杂志, 2017, 20(4): 264-271.
3. Fernandez FG, Falcoz PE, Kozower BD, et al. The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons general thoracic surgery databases: Joint standardization of variable definitions and terminology. Ann Thorac Surg, 2015, 99(1): 368-376.
4. 中国医师协会胸外科医师分会, 胸外科专业术语标准化委员会. 胸外科疾病标准化诊疗术语. 北京: 人民卫生出版社, 2017. 81-106.
5. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
6. 岑磊磊. 结肠癌根治术后并发症的Clavien-Dindo分级及其危险因素分析. 中国现代普通外科进展, 2021, 24(9): 706-710.
7. 王少东, 隋锡朝, 杨帆, 等. 早期非小细胞肺癌VATS根治术并发症预测模型的建立—前瞻性多中心研究. 中华胸心血管外科杂志, 2017, 33(2): 87-90, 102.
8. 王政. 非小细胞肺癌肺叶切除术后并发症分级及其危险因素分析. 蚌埠医学院, 2020.
9. 聂蕴韬. 改良POSSUM评分联合Clavien-Dindo分级预测胸腔镜肺手术术后严重并发症发生率的应用研究. 河北医科大学, 2018.
10. Dai W, Xie S, Zhang R, et al. Developing and validating utility parameters to establish patient-reported outcome-based perioperative symptom management in patients with lung cancer: A multicentre, prospective, observational cohort study protocol. BMJ Open, 2019, 9(10): e030726.
11. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis, 1987, 40(5): 373-383.
12. Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status—Historical perspectives and modern developments. Anaesthesia, 2019, 74(3): 373-379.
13. Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
14. Sawada S, Suehisa H, Ueno T, et al. Changes in post-operative complication and mortality rates after lung cancer resection in the 20-year period 1995-2014. Acta Med Okayama, 2016, 70(3): 183-188.
15. 夏琰, 倪铮铮, 杨洁, 等. 胸腔镜肺癌根治术术后并发症及其严重程度的危险因素分析. 中华胸心血管外科杂志, 2013, 29(8): 487-490.
16. Motono N, Ishikawa M, Iwai S, et al. Individualization of risk factors for postoperative complication after lung cancer surgery: A retrospective study. BMC Surg, 2021, 21(1): 311.
17. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
18. Dai W, Dai Z, Wei X, et al. Early patient-reported outcomes after uniportal vs. multiportal thoracoscopic lobectomy. Ann Thorac Surg, 2021, S0003-4975(21): 01674-X.
19. Wei X, Yu H, Dai W, et al. Patient-reported outcomes of video-assisted thoracoscopic surgery versus thoracotomy for locally advanced lung cancer: A longitudinal cohort study. Ann Surg Oncol, 2021, 28(13): 8358-8371.
20. Dimitrovska NT, Bao F, Yuan P, et al. Learning curve for two-port video-assisted thoracoscopic surgery lung segmentectomy. Interact Cardiovasc Thorac Surg, 2022, 34(3): 402-407.
21. Migliore M, Criscione A, Calvo D, et al. Safety of video-assisted thoracic surgery lobectomy for non-small-cell lung cancer in a low-volume unit. Future Oncol, 2016, 12(23s): 47-50.
22. 冀华逊. 非小细胞肺癌术后并发症的危险因素分析. 转化医学电子杂志, 2015, 2(11): 68-69.
23. Pennathur A, Brunelli A, Criner GJ, et al. Definition and assessment of high risk in patients considered for lobectomy for stage Ⅰ non-small cell lung cancer: The American Association for Thoracic Surgery expert panel consensus document. J Thorac Cardiovasc Surg, 2021, 162(6): 1605-1618.
24. Lugg ST, Agostini PJ, Tikka T, et al. Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax, 2016, 71(2): 171-176.
25. 姜格宁, 张雷, 朱余明, 等. 肺切除手术患者术前肺功能评估肺科共识. 中国胸心血管外科临床杂志, 2020, 27(1): 1-9.
26. Zhang Y, Jheon S, Li H, et al. Results of low-dose computed tomography as a regular health examination among Chinese hospital employees. J Thorac Cardiovasc Surg, 2020, 160(3): 824-831.
27. 孙大强, 陈平雁, 刘伦旭, 等. 11958例Ⅰ~ⅢA期非小细胞肺癌手术患者不同随访方式5年生存率比较的多中心真实世界研究. 中国胸心血管外科临床杂志, 2021, 28(6): 615-622.
28. Pompili C, McLennan Battleday F, Chia WL, et al. Poor preoperative quality of life predicts prolonged hospital stay after VATS lobectomy for lung cancer. Eur J Cardiothorac Surg, 2021, 59(1): 116-121.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Risk factors for postoperative complications Clavien-Dindo classification≥gradeⅡ after lung cancer surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content