USF-LVHN SELECT
Effects of preoperative pulmonary function on perioperative outcomes after robotic-assisted pulmonary lobectomy.
Publication/Presentation Date
3-1-2023
Abstract
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% (
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%.
ISSN
1879-1883
Published In/Presented At
Chase, C. B., Mhaskar, R., Fiedler, C., West, W. J., 3rd, Varadhan, A., Cobb, J., Cool, S., Fishberger, G., Dolorit, M., Weeden, E. E., Strang, H. E., Nguyen, D., Garrett, J. R., Moodie, C. C., Fontaine, J. P., Tew, J. R., Baldonado, J. J. A. R., & Toloza, E. M. (2023). Effects of preoperative pulmonary function on perioperative outcomes after robotic-assisted pulmonary lobectomy. American journal of surgery, S0002-9610(23)00084-3. Advance online publication. https://doi.org/10.1016/j.amjsurg.2023.02.016
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
37121787
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article