دورية أكاديمية
Evaluation of gastroesophageal reflux disease and hiatal hernia as risk factors for lobectomy complications.
العنوان: | Evaluation of gastroesophageal reflux disease and hiatal hernia as risk factors for lobectomy complications. |
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المؤلفون: | Kaminski MF; Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn., Ermer T; Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn.; London School of Hygiene & Tropical Medicine, University of London, London, United Kingdom., Canavan M; Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, Conn., Li AX; Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn., Maduka RC; Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn., Zhan P; Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn., Boffa DJ; Division of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn., Case MD; Division of Interventional Radiology, Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Conn. |
المصدر: | JTCVS open [JTCVS Open] 2022 Jun 03; Vol. 11, pp. 327-345. Date of Electronic Publication: 2022 Jun 03 (Print Publication: 2022). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Ltd Country of Publication: Netherlands NLM ID: 101768541 Publication Model: eCollection Cited Medium: Internet ISSN: 2666-2736 (Electronic) Linking ISSN: 26662736 NLM ISO Abbreviation: JTCVS Open Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: [Amsterdam, The Netherlands] : Elsevier Ltd., [2020]- |
مستخلص: | Objective: Up to 40% of lobectomies are complicated by adverse events. Gastroesophageal reflux disease (GERD) and hiatal hernia have been associated with morbidity across a range of clinical scenarios, yet their relation to recovery from pulmonary resection is understudied. We evaluated GERD and hiatal hernia as predictors of complications after lobectomy for lung cancer. Methods: Lobectomy patients at Yale-New Haven Hospital between January 2014 and April 2021 were evaluated for predictors of 30-day postoperative complications, pneumonia, atrial arrhythmia, readmission, and mortality. Multivariable regression models included sociodemographic characteristics, body mass index, surgical approach, cardiopulmonary comorbidities, hiatal hernia, GERD, and preoperative acid-suppressive therapy as predictors. Results: Overall, 824 patients underwent lobectomy, including 50.5% with a hiatal hernia and 38.7% with GERD. The median age was 68 [interquartile range, 61-74] years, and the majority were female (58.4%). At least 1 postoperative complication developed in 39.6% of patients, including atrial arrhythmia (11.7%) and pneumonia (4.1%). Male sex (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.11-2.06, P = .01), age ≥70 years (OR, 1.55; 95% CI, 1.13-2.11, P = .01), hiatal hernia (OR, 1.40; 95% CI, 1.03-1.90, P = .03), and intraoperative packed red blood cells (OR, 4.80; 95% CI, 1.51-15.20, P = .01) were significant risk factors for developing at least 1 postoperative complication. Hiatal hernia was also a significant predictor of atrial arrhythmia (OR, 1.64; 95% CI, 1.02-2.62, P = .04) but was not associated with other adverse events. Conclusions: Our findings indicate that hiatal hernia may be a novel risk factor for complications, especially atrial arrhythmia, following lobectomy that should be considered in the preoperative evaluation of lung cancer patients. (© 2022 The Author(s).) |
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معلومات مُعتمدة: | T32 CA233414 United States CA NCI NIH HHS; T35 DK104689 United States DK NIDDK NIH HHS; UL1 TR001863 United States TR NCATS NIH HHS |
فهرسة مساهمة: | Keywords: BMI, body mass index; CI, confidence interval; CT, computed tomography; GERD; GERD, gastroesophageal reflux disease; OR, odds ratio; RBC, red blood cell; atrial arrhythmia; hiatal hernia; lobectomy; lung cancer; postoperative complications |
تواريخ الأحداث: | Date Created: 20220929 Latest Revision: 20240517 |
رمز التحديث: | 20240517 |
مُعرف محوري في PubMed: | PMC9510864 |
DOI: | 10.1016/j.xjon.2022.05.017 |
PMID: | 36172441 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2666-2736 |
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DOI: | 10.1016/j.xjon.2022.05.017 |