Analysis Of Risk Factors For Conversion To Thoracotomy During Video-assisted Thoracic Surgery Lobectomy For Non-small-cell Lung Cancer

Objective: To analyze and discuss the risk factors of video-assisted thoracoscopic lobectomy conversion to thoracotomy for non-small cell lung cancer,so as to accurately grasp the timing of thoracoscopic conversion to thoracotomy.Methods:The data of patients with non-small cell lung cancer who underwent lobectomy from January 2012 to November 2019 in the Eastern District of the Fourth Hospital of Hebei Medical University were retrospectively analyzed.Among them,44 cases were converted to thoracotomy by video-assisted thoracoscopy,459 cases were directly subjected to video-assisted thoracoscopic lobectomy as thoracoscopic group.The information of sex,age,smoking history,pulmonary tuberculosis history,pathological type,tumor location,extensive pleural adhesion,development of interlobar fissure,tight connection of lymph nodes of the two groups were analyzed by univariate analysis,binary multivariate Logistic regression analysis was used for variate analysis.Results: Univariate analysis of the two groups of dates,in history of pulmonary tuberculosis(?2=6.939,P=0.008),upper lobe tumors(?2=4.613,P=0.032),extensive pleural adhesions(?2=9.120,P=0.003),interlobar fissure dysplasia(?2=5.973,P=0.015),tight connection between lymph nodes and surrounding tissues(?2=101.094,P(27)0.001),there was significant difference between the two groups.Multivariate Logistic regression analysis showed that extensive pleural adhesion(OR=3.928,95%CI=1.701?9.074),development of interlobar fissure(OR=4.468,95%CI=1.409?14.163)and tight connection of lymph nodes(OR=62.128,95%CI=17.696?218.124)were independent risk factors for thoracotomy.Conclusions:The history of pulmonary tuberculosis,upper lobe tumors,extensive pleural adhesions,interlobar fissure dysplasia and tight connection of lymph nodes are the risk factors of thoracoscopic lobectomy conversion to thoracotomy.Extensive pleural adhesions,development of interlobar fissure and tight connection of lymph nodes are also the independent risk factors of thoracoscopic lobectomy conversion to thoracotomy.