Clinical Research On Chronic Cough After Video Assist Thoracoscopic Surgery For Pulmonary Tumors

Objective:To explore the potential influential factors of chronic cough after video assist thoracoscopic surgery for pulmonary tumors.Methods:A retrospective clinical research was conducted in the Affiliated Hospital of Soochow University from January 2018 to December 2018.A total of 238 patients who underwent video assist thorascopic surgery for pulmonary tumor were involved in this study.All patients were screened and then divided into two groups based on the criteria of whether suffered from longer than 8 weeks chronic cough.Detailed analyses were made for each group.Factors we considered included demographic factors,the size of tumor,the location of tumor,the types of surgical procedure,the intraoperative details,the length of postoperative hospital stay,the incurrence of complications and internal diseases.Data relating to those factors were collected and then analyzed using standard statistic tools.And then finding the serious chronic cough patients based on the cough degree scale.Factors related with chronic cough were analyzed further.Result:A total of 172 patients remained after screening.There were 55(31.98%)patients met the criteria of chronic cough.The difference between these two groups was significant.Mediastinal lymphadenectomy(P<0.001),the location of tumor(P=0.001),the types of surgical procedure(P<0.001),upper lobe resection(P=0.012),bronchial stump processing(P=0.009)and smoking history(P<0.001)showed statistically significant between these two group.However,the age(P= 0.115),gender(P=0.055),the type of tumor(P=0.262),the size of tumor(P=0.251),pleural adhesions(P=0.179),postoperative air leakage(P=0.231)and the days of thoracic drainage(P=0.064)showed no difference between these two groups.Logistic multivariate regression analysis revealed that mediastinal lymphadenectomy(P<0.001),the location of tumor(P=0.001),the types of surgical procedure(P=0.032),upper lobe resection(P=0.006),bronchial stump processing(P=0.025)was independent risk factors for postoperative chronic cough.Mediastinal lymphadenectomy(P<0.001)and lobectomy(P<0.001;P=0.029)showed higher incidence of serious chronic cough.Conclusion:Mediastinal lymphadenectomy,the location of tumor,the types of surgical procedure,upper lobe resection,bronchial stump processing and smoking history are associated with chronic cough obviously.Mediastinal lymphadenectomy,the location of tumor,the types of surgical procedure,upper lobe resection,bronchial stump processing was independent risk factors for postoperative chronic cough.Mediastinal lymphadenectomy and lobectomy have higher incidence of serious chronic cough.Therefore,choosing appropriate surgical methods and paying attention to the management of mediastinal lymph nodes during operation could improve the symptom of chronic cough after operation and improve their quality of life.