June Yeop Lee, Joonseok Lee, Varissara Javakijkarnjanakul, Beatrice Chia-Sui Shih, Woohyun Jung, Jae Hyun Jeon, Kwhanmien Kim, Sanghoon Jheon, Sukki Cho
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引用次数: 0
Abstract
Background: This study aimed to evaluate the long-term impact of postoperative prolonged air leak (PAL) on pulmonary function.
Methods: We enrolled 1,316 patients with pathologic stage I-III lung cancer who underwent lobectomy. The cohort was divided into 2 groups: those who experienced PAL (n=55) and those who did not (n=1,261). Propensity score matching was conducted at a 1:4 ratio, resulting in 49 patients in the PAL group and 189 in the non-PAL group. Changes in pulmonary function were compared among preoperative, 6-month postoperative, and 12-month postoperative measurements between the 2 groups.
Results: The variables used for propensity score matching included age, sex, smoking history, body mass index, baseline pulmonary function, pathologic stage, and surgical approach. All standardized mean differences were less than 0.1. Six months postoperatively, the PAL group showed a greater reduction in both forced expiratory volume in 1 second (FEV1) (-13.0% vs. -10.0%, p=0.041) and forced vital capacity (FVC) (-15.0% vs. -9.0%, p<0.001) than the non-PAL group. In cases of upper lobectomy, there were no significant differences in FEV1 changes between the PAL and non-PAL groups at both 6 and 12 months. However, in lower lobectomy, the PAL group demonstrated a more pronounced decrease in FEV1 (-14.0% vs. -11.0%, p=0.057) and FVC (-20.0% vs. -13.0%, p=0.006) than the non-PAL group at 6 months postoperatively.
Conclusion: Postoperative PAL delayed the recovery of pulmonary function after lobectomy. These effects were markedly more pronounced after lower lobectomy than after upper lobectomy.
背景:本研究旨在评估术后长时间漏气(PAL)对肺功能的长期影响:本研究旨在评估术后长期漏气(PAL)对肺功能的长期影响:我们招募了 1316 名接受肺叶切除术的病理 I-III 期肺癌患者。患者分为两组:经历过 PAL 的患者(55 人)和未经历过 PAL 的患者(1261 人)。按 1:4 的比例进行倾向得分匹配,结果 PAL 组有 49 名患者,非 PAL 组有 189 名患者。比较了两组患者术前、术后 6 个月和术后 12 个月的肺功能变化:用于倾向得分匹配的变量包括年龄、性别、吸烟史、体重指数、基线肺功能、病理分期和手术方式。所有标准化平均差异均小于 0.1。术后 6 个月,PAL 组的 1 秒用力呼气容积(FEV1)(-13.0% vs. -10.0%,p=0.041)和用力肺活量(FVC)(-15.0% vs. -9.0%,p1)在 6 个月和 12 个月的变化均大于非 PAL 组。然而,在下肺叶切除术中,术后6个月时,PAL组的FEV1(-14.0% vs. -11.0%,p=0.057)和FVC(-20.0% vs. -13.0%,p=0.006)比非PAL组下降更明显:结论:术后 PAL 会延迟肺叶切除术后肺功能的恢复。这些影响在下肺叶切除术后比上肺叶切除术后明显。