دورية أكاديمية
Effects of preoperative pulmonary function on perioperative outcomes after robotic-assisted pulmonary lobectomy.
| العنوان: | Effects of preoperative pulmonary function on perioperative outcomes after robotic-assisted pulmonary lobectomy. |
|---|---|
| المؤلفون: | Chase CB; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: cbchase@usf.edu., Mhaskar R; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: rmhaskar@usf.edu., Fiedler C; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: colefiedler@usf.edu., West WJ 3rd; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: westw@usf.edu., Varadhan A; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: ajayvaradhan@usf.edu., Cobb J; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: cobb3@usf.edu., Cool S; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: cool@usf.edu., Fishberger G; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: gfishberger@usf.edu., Dolorit M; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: dolorit@usf.edu., Weeden EE; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: eeweeden@usf.edu., Strang HE; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: harrisonelliotstrang@usf.edu., Nguyen D; Department of Medical Education, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: diepnguyen@usf.edu., Garrett JR; Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: joe.garrett@moffitt.org., Moodie CC; Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: carla.moodie@moffitt.org., Fontaine JP; Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: jacques.fontaine@moffitt.org., Tew JR; Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA. Electronic address: jenna.tew@moffitt.org., Baldonado JJAR; Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: jobelle.baldonado@moffitt.org., Toloza EM; Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, FL, USA. Electronic address: eric.toloza@moffitt.org. |
| المصدر: | American journal of surgery [Am J Surg] 2023 Jul; Vol. 226 (1), pp. 128-132. Date of Electronic Publication: 2023 Mar 01. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0370473 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1883 (Electronic) Linking ISSN: 00029610 NLM ISO Abbreviation: Am J Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Belle Mead, NJ : Excerpta Medica Original Publication: New York. |
| مواضيع طبية MeSH: | Lung* , Robotic Surgical Procedures*, Humans ; Lung Diseases/surgery ; Lung Neoplasms/surgery ; Pneumonectomy/methods ; Retrospective Studies ; Thoracic Surgery, Video-Assisted |
| مستخلص: | Introduction: Effects of pulmonary function test (PFT) results on perioperative outcomes were investigated after robotic-assisted video-thoracoscopic (RAVT) pulmonary lobectomy. Methods: We retrospectively analyzed 706 consecutive patients who underwent RAVT lobectomy by one surgeon over 10.8 years. Preoperative (preop) forced expiratory volume in 1 s as a percent of predicted (FEV1%) was used to group patients as having normal FEV1% (≥80%) versus reduced FEV1% (<80%). Demographics, preop comorbidities, intraoperative (intraop) and postoperative (postop) complications, perioperative outcomes, and median survival time (MST) were compared across patients with normal vs. reduced FEV1% using Chi-Square (X 2 ), Fisher's Exact test, Student's t-test, Kruskal-Wallis test, or Kaplan-Meier analysis respectively, with significance at p ≤ 0.05. Multivariable analysis was performed for perioperative outcomes to investigate the differences across patients in the FEV1% groups. Results: There were 470 patients with normal FEV1% and 236 patients with reduced FEV1%. The two FEV1% groups did not differ in intraop or postop complication rates, except for higher postop other arrhythmia requiring intervention (p = 0.004), prolonged air leak >5 days (p = 0.002), mucous plug formation (p = 0.009), hypoxia (p < 0.001), and pneumonia (p = 0.002), and total postop complications (p < 0.001) in reduced-FEV1% patients. Reduced FEV1% correlated with increased intraop estimated blood loss (p < 0.0001) and skin-to-skin operative time (p < 0.0001). Median overall survival in patients with normal FEV1% was 93.20 months (95% CI: 76.5-126.0) versus 58.9 months (95% CI: 50.4-68.4) in patients with reduced FEV1% (p = 0.0004). Conclusion: Patients should have PFTs conducted before surgery to determine at-risk patients. However, RAVT pulmonary lobectomy is feasible and safe even in patients with reduced FEV1%. Competing Interests: Declaration of competing interest E.M.T. and J.P.F. have had financial relationships with Intuitive Surgical, Inc., in the form of honoraria received as robotic thoracic surgery observation sites and proctors. None of the other authors have any conflicts of interest to disclose. (Copyright © 2023. Published by Elsevier Inc.) |
| فهرسة مساهمة: | Keywords: Lobectomy; Outcomes; Pulmonary function; Robotic |
| تواريخ الأحداث: | Date Created: 20230430 Date Completed: 20231108 Latest Revision: 20231108 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.amjsurg.2023.02.016 |
| PMID: | 37121787 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-1883 |
|---|---|
| DOI: | 10.1016/j.amjsurg.2023.02.016 |