Study On Postoperative Complications After Complete Video-assisted Thoracoscopic Surgery Bronchial Sleeve Lobectomy

Objective:To investigate the occurrence factors of thoracoscopic bronchial sleeve resection postoperative complications and related effects.Method:The clinical data of 63 patients undergoing video-assisted thoracoscopic surgery of bronchial resection and reconstruction Lobectomy in 2016-2018 were analyzed retrospectively.The sex,age,neoadjuvant chemotherapy,the site of the CT report before operation,the maximum diameter of the tumor,the calcification of the ipsilateral hilar lymph node and the mediastinal lymph node metastasis were analyzed.The intraoperative blood loss,operative time and lobar consolidation were calculated.The postoperative complications of arrhythmia,pneumonia,chylothorax,persistent pulmonary leakage(>7d),severe subcutaneous emphysema and so on were analyzed.The incidence of complications was compared with the related literature at China and abroad,and the similarities and differences were analyzed.The patients were divided into 2 groups according to whether or not suffered by postoperative complications.The independent sample t test,chi square test or the exact Fisher probability method were used to compare the differences between the groups.The independent influence of the multiple factor Logistic regression analysis was used to explore the influence of postoperative complications.Result:Among the 63 cases,postoperative complications occurred in 10 cases,including 3 cases of pulmonary infection,4 cases of chylothorax,and 2 cases of severe subcutaneous gas accumulation.The incidence of complications(P=15.83%)is basically the same as that reported in the literature.There were no statistically significant differences in gender(P>0.999),age(P=0.173),neoadjuvant chemotherapy(P=0.508),mediastinal lymph node enlargement(P=0.508),pulmonary lobectomy(P>0.05),tumor size(P=0.513),operation length(P=0.142)and intraoperative hemorrhage(P=0.639)in two groups.The difference of lymph node calcification(P=0.003)was statistically significant.Multiple factor Logistic regression analysis showed that the amount of bleeding during the operation of neoadjuvant chemotherapy for neoadjuvant chemotherapy was not an independent risk factor for postoperative complications.Conclusion:Thoracoscopic lobectomy of the bronchotomy is safe and feasible in the selection of appropriate cases and is practicable on the premise of skilled thoracoscopy.The incidence of postoperative complications is associated with the incidence of postoperative complications and patients' age,sex,neoadjuvant chemotherapy,pulmonary lobectomy and mediastinal lymph node enlargement and tumor size.There was no significant correlation between small,long operation time and intraoperative blood loss.There is a significant correlation between preoperative calcification and hilar lymph node calcification.For such patients,the choice of surgical procedures should be cautious.