Abstract:
BACKGROUND AND OBJECTIVES:Prolonged air leaks (PAL) are the most frequent complication after lobectomy for non-small cell lung cancer, even in case of minimally invasive approaches. We developed a novel score to identify high-risk patients for PAL during minimally invasive lobectomy. METHODS:A dedicated database was created. We investigated preoperative candidate features and specific intraoperative variables. Univariate and subsequent logistic regression analysis with bootstrap resampling have been used. Model performance has been assessed by reckoning the area under the receiver operating characteristics curve and the Hosmer-Lemeshow goodness of fit. RESULTS:PAL (>5 days) occurred in 72 (15.69%) patients. Five variables emerged from the model. Each one was assigned a score to provide a cumulative scoring system: forced expiratory volume in 1 second below 86% (P = 0.004, 1.5 points), body mass index <24 ( P = 0.002, 1 point), active smoking ( P = 0.001, 1.5 points), incomplete fissures ( P = 0.004, 1.5 points), and adhesions ( P = 0.0001, 1 point). The new score provided a stratification into four risk classes. CONCLUSIONS:The risk score incorporates either general or more specific variables, providing a risk stratification that could be readily applied intra- and postoperatively. Henceforth, specific technical and management measures could be properly allocated to curb PAL.
journal_name
J Surg Oncoljournal_title
Journal of surgical oncologyauthors
Viti A,Socci L,Congregado M,Ismail M,Nachira D,Muñoz CG,Bolufer S,Rückert JC,Margaritora S,Terzi Adoi
10.1002/jso.25289subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1285-1291issue
8eissn
0022-4790issn
1096-9098journal_volume
118pub_type
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