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Comparative Study
。 2012年8月;215(2):206-15.
DOI：10.1016 / J.Jamcollsurg.2012.04.016。 EPUB 2012年6月6日。

影响肺癌解剖切除后术治疗方法和随后短期结果的因素

约瑟夫菲利普斯1那 Ryan P Merkow那 克伦谢尔曼那 Malcolm M DeCamp那 David J Bentrem.那 Karl Y Bilimoria
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Comparative Study

影响肺癌解剖切除后术治疗方法和随后短期结果的因素

约瑟夫菲利普斯等等。 J Am Coll Surg。 。

Abstract

Background:Previous studies evaluating video-assisted thoracoscopic surgery (VATS) for lung cancer are single-institution series, suffer from small sample size, or use administrative or self-reported databases. Using a multi-institutional, standardized, and audited surgical outcomes database, our objectives were to examine preoperative factors associated with undergoing VATS vs open resection and assess subsequent perioperative outcomes.

Study design:The American College of Surgeons National Surgical Quality Improvement Program Participant Use File was used to identify patients who underwent anatomic resection (eg, segmentectomy, lobectomy, and bi-lobectomy) for primary lung cancer (2005 to 2010). Multiple logistic regression models, including propensity scores, were developed to assess preoperative factors associated with undergoing VATS and the risk-adjusted association between operative approach and 30-day outcomes.

结果：2,353例接受切除术的患者，经过74％的开放胸廓切开术（OT）和26％的大桶。经回归混淆后，与经过大桶的因素是患者年龄超过75岁的患者年龄（赔率比[或] = 1.41; 95％CI，1.05-1.90），西班牙裔民族（或= 2.52; 95％CI，1.69-3.77）和心肌手术训练（或= 1.68; 95％CI，1.37-2.07）。接受OT的患者具有较高的任何不良事件发育的可能性更高（24％与14％;或= 1.76; 95％CI，1.35-2.29），特别是肺炎和败血症/脓毒症休克。OT组中位的住宿时间明显更长（7天4天; P <0.001）。在对混凝徒的回归后，死亡率对VATS vs OT没有显着差异。

Conclusions:In addition to patient factors, surgeon training can play a role in determining the operative approach offered to patients. Patients selected for VATS had a lower 30-day morbidity and shorter length of stay compared with OT anatomic resection for primary lung cancer.

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