Design Appropriate Incision Length for Uniportal Video-Assisted Thoracoscopic Lobectomy: Take into Account Safety and Minimal Invasiveness.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-03-01 Epub Date: 2022-11-29 DOI:10.1055/s-0042-1758825
Chen-Ye Shao, Can-Hui Liu, Qian-He Ren, Xiao-Long Liu, Guo-Hua Dong, Sheng Yao
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引用次数: 0

Abstract

Background:  There is no criterion on the length of the uniportal video-assisted thoracoscopic surgery (UVATS) incision when performing lobectomy. We aimed to develop a nomogram to assist surgeons in designing incision length for different individuals.

Methods:  A cohort consisting of 290 patients were enrolled for nomogram development. Univariate and multivariate logistic regression analyses were performed to identify candidate variables among perioperative characteristics. C-index and calibration curves were utilized for evaluating the performance of the nomogram. Short-term outcomes of nomogram-predicted high-risk patients were compared between long incision group and conventional incision group.

Results:  Of 290 patients, 150 cases (51.7%) were performed incision extension during the surgery. Age, tumor size, and tumor location were identified as candidate variables related with intraoperative incision extension and were incorporated into the nomogram. C-index of the nomogram was 0.75 (95% confidence interval: 0.6961-0.8064), indicating the good predictive performance. Calibration curves presented good consistency between the nomogram prediction and actual observation. Of high-risk patients identified by the nomogram, the long incision group (n = 47) presented shorter duration of operation (p = 0.03), lower incidence of total complications (p = 0.01), and lower incidence of prolonged air leak (p = 0.03) compared with the conventional incision group (n = 55).

Conclusion:  We developed a novel nomogram for predicting the risk of intraoperative incision extension when performing uniportal video-assisted thoracoscopic lobectomy. This model has the potential to assist clinicians in designing the incision length preoperatively to ensure both safety and minimal invasiveness.

为单孔视频辅助胸腔镜肺叶切除术设计合适的切口长度:兼顾安全性和微创性
背景:在进行肺叶切除术时,单孔视频辅助胸腔镜手术(UVATS)切口的长度没有标准。我们旨在开发一个提名图,以帮助外科医生针对不同个体设计切口长度:方法:我们招募了由 290 名患者组成的队列来制定提名图。进行了单变量和多变量逻辑回归分析,以确定围手术期特征中的候选变量。利用 C 指数和校准曲线来评估提名图的性能。比较了长切口组和传统切口组根据提名图预测的高风险患者的短期疗效:结果:在 290 例患者中,150 例(51.7%)在手术中进行了切口延长。年龄、肿瘤大小和肿瘤位置被确定为与术中切口扩展相关的候选变量,并被纳入提名图中。提名图的 C 指数为 0.75(95% 置信区间:0.6961-0.8064),显示了良好的预测性能。校准曲线显示,提名图预测结果与实际观察结果之间具有良好的一致性。在提名图识别出的高危患者中,长切口组(n = 47)与传统切口组(n = 55)相比,手术时间更短(p = 0.03),总并发症发生率更低(p = 0.01),漏气时间更长(p = 0.03):我们开发了一种新的提名图,用于预测单孔视频辅助胸腔镜肺叶切除术术中切口扩展的风险。该模型可帮助临床医生在术前设计切口长度,以确保安全和微创。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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