scholarly journals Excessive intravenous crystalloid infusion after video-assisted thoracoscopic surgery lobectomy is associated with postoperative pneumonia

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Rong Yang ◽  
Chengli Du ◽  
Jinming Xu ◽  
Linpeng Yao ◽  
Siying Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Thoracoscopic Surgery ◽  
Postoperative Pneumonia ◽  
Lung Lobe ◽  
Video Assisted ◽  
Crystalloid Infusion ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Video-assisted thoracoscopic surgery has been widely used in thoracic surgery worldwide. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy. Methods A retrospective analysis of adult patients undergoing video-assisted thoracoscopic surgery lobectomy between 2016 and 05 and 2017–04 was performed. We used univariate analyses and multivariate analyses to examine risk factors for postoperative pneumonia after lobectomy. Results The incidence of postoperative pneumonia was 19.7% (n = 143/727). Patients with postoperative pneumonia had a higher postoperative length of stay and total hospital care costs when compared to those without postoperative pneumonia. Multivariate analysis showed that body mass index grading ≥24.0 kg/m2 (vs. <24.0 kg/m2: odds ratio 1.904, 95% confidence interval 1.294–2.802, P = 0.001) and right lung lobe surgery (vs. left lung lobe surgery: odds ratio 1.836, 95% confidence interval 1.216–2.771, P = 0.004) were independent risk factors of postoperative pneumonia. Total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL was also identified as the risk factors (vs. 1000 to < 1500 mL: odds ratio 2.060, 95% confidence interval 1.302–3.260, P = 0.002). Conclusions Major risk factors for postoperative pneumonia following video-assisted thoracoscopic surgery lobectomy are body mass index grading ≥24.0 kg/m2, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL.

scholarly journals Risk factors for postoperative recurrence of spontaneous pneumothorax treated by video-assisted thoracoscopic surgery

2015 ◽  
Vol 20 (5) ◽  
pp. 647-652 ◽  
Author(s):  
Andrea Imperatori ◽  
Nicola Rotolo ◽  
Marco Spagnoletti ◽  
Luigi Festi ◽  
Fabio Berizzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Postoperative Recurrence ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Risk Factors Predisposing to Prolonged Air Leak After Video-Assisted Thoracoscopic Surgery for Spontaneous Pneumothorax

2014 ◽  
Vol 97 (3) ◽  
pp. 1008-1013 ◽  
Author(s):  
Lei Jiang ◽  
Gening Jiang ◽  
Yuming Zhu ◽  
Wang Hao ◽  
Lei Zhang
Keyword(s):  
Risk Factors ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Air Leak ◽  
Video Assisted ◽  
Prolonged Air Leak ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Incidence and Risk Factors for Chronic Postsurgical Pain Following Video-assisted Thoracoscopic Surgery: a Retrospective Study

2021 ◽  
Author(s):  
Yingying Zhang ◽  
Rong Zhou ◽  
Bailing Hou ◽  
Suhong Tang ◽  
Jing Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Thoracoscopic Surgery ◽  
Rescue Analgesia ◽  
Postsurgical Pain ◽  
Video Assisted ◽  
Chronic Postsurgical Pain ◽  
Severe Chronic Pain ◽  
Independent Risk Factors ◽  
Video Assisted Thoracoscopic Surgery

Abstract Backgroud: Video-assisted thoracoscopic surgery (VATS) has been widely used as an alternative for thoracotomy, but the reported incidence of chronic postsurgical pain (CPSP) following VATS varied widely. The purpose of this study was to investigate the incidence and risk factors for CPSP after VATS. Methods: We retrospectively collected preoperative demographic, anesthesiology, and surgical factors in a cohort of patients undergoing VATS between January 2018 and October 2020. Patients were interviewed via phone survey for pain intensity, and related medical treatment 3 months after VATS. Univariate and multivariate analysis were used to explore independent risk factors associated with CPSP.Results: 2,348 patients were included in our study. The incidence of CPSP after VATS were 43.99% (n = 1,033 of 2,348). Within those suffering CPSP, 14.71% (n = 152 of 1,033) patients reported moderate or severe chronic pain. Only 15.23% (n = 23 of 152) patients with moderate to severe chronic pain sought active analgesic therapies. According to multivariable analysis, age ＜ 65 years (OR 1.278, 95% CI 1.057-1.546, P = 0.011), female (OR 1.597, 95% CI 1.344-1.898, P < 0.001), education level less than junior school (OR 1.295, 95% CI 1.090-1.538, P = 0.003), preoperative pain (OR 2.564, 95% CI 1.696-3.877, P < 0.001), consumption of rescue analgesia postoperative (OR 1.248, 95% CI 1.047-1.486, P = 0.013), consumption of sedative hypnotic postoperative (OR 2.035, 95% CI 1.159-3.574, P = 0.013), subcutaneous emphysema of chest wall postoperative (OR 1.255, 95% CI 1.000-1.575, P = 0.050), and history of postoperative wound infection (OR 5.949, 95% CI 1.344-1.898, P < 0.001) were independent risk factors for CPSP development.Conclusions: CPSP remains a challenge in clinic because half of patients may develop CPSP after VATS. Trial registration: Chinese Clinical Trial Registry (ChiCTR2100045765), 2021/04/24

scholarly journals Point of Care Ultrasound to Identify Diaphragmatic Dysfunction after Thoracic Surgery

2019 ◽  
Vol 131 (2) ◽  
pp. 266-278 ◽  
Author(s):  
S. Spadaro ◽  
S. Grasso ◽  
M. Dres ◽  
A. Fogagnolo ◽  
F. Dalla Corte ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Thoracoscopic Surgery ◽  
Point Of Care ◽  
Pulmonary Complications ◽  
Point Of Care Ultrasound ◽  
Postoperative Pulmonary Complications ◽  
Diaphragmatic Dysfunction ◽  
Video Assisted ◽  
Diaphragmatic Function ◽  
Video Assisted Thoracoscopic Surgery

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Postoperative diaphragmatic dysfunction after thoracic surgery is underestimated due to the lack of reproducible bedside diagnostic methods. We used point of care ultrasound to assess diaphragmatic function bedside in patients undergoing video-assisted thoracoscopic or thoracotomic lung resection. Our main hypothesis was that the thoracoscopic approach may be associated with lower incidence of postoperative diaphragm dysfunction as compared to thoracotomy. Furthermore, we assessed the association between postoperative diaphragmatic dysfunction and postoperative pulmonary complications. Methods This was a prospective observational cohort study. Two cohorts of patients were evaluated: those undergoing video-assisted thoracoscopic surgery versus those undergoing thoracotomy. Diaphragmatic dysfunction was defined as a diaphragmatic excursion less than 10 mm. The ultrasound evaluations were carried out before (preoperative) and after (i.e., 2 h and 24 h postoperatively) surgery. The occurrence of postoperative pulmonary complications was assessed up to 7 days after surgery. Results Among the 75 patients enrolled, the incidence of postoperative diaphragmatic dysfunction at 24 h was higher in the thoracotomy group as compared to video-assisted thoracoscopic surgery group (29 of 35, 83% vs. 22 of 40, 55%, respectively; odds ratio = 3.95 [95% CI, 1.5 to 10.3]; P = 0.005). Patients with diaphragmatic dysfunction on the first day after surgery had higher percentage of postoperative pulmonary complications (odds ratio = 5.5 [95% CI, 1.9 to 16.3]; P = 0.001). Radiologically assessed atelectasis was 46% (16 of 35) in the thoracotomy group versus 13% (5 of 40) in the video-assisted thoracoscopic surgery group (P = 0.040). Univariate logistic regression analysis indicated postoperative diaphragmatic dysfunction as a risk factor for postoperative pulmonary complications (odds ratio = 5.5 [95% CI, 1.9 to 16.3]; P = 0.002). Conclusions Point of care ultrasound can be used to evaluate postoperative diaphragmatic function. On the first postoperative day, diaphragmatic dysfunction was less common after video-assisted than after the thoracotomic surgery and is associated with postoperative pulmonary complications.

Video-Assisted Thoracoscopic Lobectomy in Children: Safety and Efficacy Compared with the Conventional Thoracotomy Approach

2012 ◽  
Vol 7 (6) ◽  
pp. 394-398 ◽  
Author(s):  
Yong Won Seong ◽  
Byung Su Yoo ◽  
Jin Tae Kim ◽  
In Kyu Park ◽  
Chang Hyun Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Patients ◽  
Thoracoscopic Surgery ◽  
Univariate Analysis ◽  
Lung Ventilation ◽  
Vats Lobectomy ◽  
Single Lung Ventilation ◽  
Video Assisted ◽  
History Of ◽  
Video Assisted Thoracoscopic Surgery

Objective There have been only small numbers of reports for video-assisted thoracoscopic surgery (VATS) lobectomy in children because of its technically demanding aspects. This study was performed to evaluate the safety and the efficacy of the VATS lobectomy compared with the conventional lobectomy by thoracotomy and to investigate the risk factors of thoracotomy conversion. Methods From May 2005 to October 2010, a total of 37 pediatric patients underwent VATS lobectomy and 28 pediatric patients underwent conventional lobectomy. The VATS lobectomy group consisted of relatively older patients compared with the thoracotomy group. Clinical outcomes from the two groups were analyzed and compared. Results Of the 37 patients in the VATS group, 8 patients (23%) required thoracotomy conversion and 29 patients (77%) were successfully operated on thoracoscopically. There were no in-hospital mortalities in both groups. Annual thoracotomy conversion rate has decreased from 50% in 2005 to 9% in 2010. There were no significant differences in the outcome between the VATS group and the thoracotomy group. Morbidities in the VATS group included prolonged drainage longer than 7 days (two patients), prolonged air leakage (two patients), and bleeding (one patient). There was no difference in the incidence of morbidities between the two groups. Univariate analyses revealed failure of single-lung ventilation (P = 0.007) and history of pneumonia (P = 0.001) to be risk factors of thoracotomy conversion. Conclusions Video-assisted thoracoscopic surgery lobectomy in children is a safe and effective treatment modality, with results comparable with those of conventional lobectomy. In the univariate analysis, failure of single-lung ventilation and history of pneumonia were the two factors related to thoracotomy conversion.

scholarly journals Group-based trajectory analysis of postoperative pain in epidural analgesia for video-assisted thoracoscopic surgery and risk factors of rebound pain

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Wen-Kuei Chang ◽  
Yi-Shiuan Li ◽  
Hsiang-Ling Wu ◽  
Ying-Hsuan Tai ◽  
Shih-Pin Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Trajectory Analysis ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Preoperative bacterial culture can predict severe pneumonia in patients receiving esophagectomy

2021 ◽  
Author(s):  
Akinao Kaneta ◽  
Takahiro Sato ◽  
Hiroshi Nakano ◽  
Takuro Matsumoto ◽  
Takeshi Tada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Pathogenic Bacteria ◽  
Bacterial Culture ◽  
Severe Pneumonia ◽  
Wilcoxon Test ◽  
University Hospital ◽  
Postoperative Pneumonia ◽  
Categorical Variables

Abstract Background Postoperative pneumonia is one of the major complications after esophagectomy. The aim of this study was to determine whether bacterial cultures before esophagectomy could predict occurrence of postoperative pneumonia and help treatment strategies for postoperative pneumonia. Methods Sixty-nine patients who underwent subtotal esophagectomy at Fukushima Medical University hospital between January 2017 and May 2021 were included in this study. We collected sputum, oral and/or nasopharyngeal swabs for bacterial culture preoperatively from all patients and from those who were suspected of postoperative pulmonary infections. We compared cultured pathogenic bacteria obtained preoperatively and postoperatively from patients who developed postoperative pneumonia, and investigated their association with incidence of postoperative pneumonia. Fisher’s exact test was used to compare categorical variables between groups, and Wilcoxon test was used to compare continuous variables. Risk factors for postoperative pneumonia and severe pneumonia were analyzed using multivariate logistic regression models. Results Postoperative pneumonia occurred in 22 (31%) of the 69 patients, and 13 of the 22 patients were classified as with severe pneumonia. Multivariate analysis revealed that longer operative duration (for 30 minutes increase; odds ratio 1.27, 95% confidence interval 1.01–1.51, p=0.039) and positivity for preoperative bacterial culture (odds ratio 5.03, 95% confidence interval 1.31–19.2, p=0.018) were independent risk factors for severe postoperative pneumonia, but not for all incidence of postoperative pneumonia. Of note, in only 5 out of the 22 patients with pneumonia, the same pathogen species were detected preoperatively and after the onset of pneumonia. Conclusions In conclusion, our results implied that preoperative bacterial culture may be useful to predict severe postoperative pneumonia. However, it may not be useful in determining pathogenic bacteria responsible for postoperative pneumonia.

Predictors of early mortality after surgical treatment of infective endocarditis: a single-center experience

Perfusion ◽  
2019 ◽  
Vol 35 (4) ◽  
pp. 290-296 ◽  
Author(s):  
Povilas Jakuska ◽  
Egle Ereminiene ◽  
Egle Muliuolyte ◽  
Vidas Kosys ◽  
Lukas Pavlavičius ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Early Mortality ◽  
Aortic Cross Clamp ◽  
Aureus Infection

Objective: Surgical management of infective endocarditis continues to be challenging and is associated with significant morbidity and mortality. The objective of our study was to determine the risk factors and conditions associated with poor early infective endocarditis surgical treatment outcomes—30-day postoperative mortality. Methods: A total of 124 patients who underwent surgery for infective endocarditis at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics from January 2010 to December 2017 were retrospectively included in this study. The primary endpoints were 30-day postoperative mortality and identification of risk factors associated with it. Secondary endpoints were early postoperative outcomes and complication rates. Results: During the study period, 124 patients with infective endocarditis underwent cardiac surgery, presenting an overall 30-day postoperative mortality rate of 10.48%. Mean age was 58 ± 14.4 years with 95 (76.61%) males. Independent predictive factors of early mortality were age >63 years (odds ratio = 6.4, 95% confidence interval = 1.66-24.66, p = 0.003), body mass index >30 kg/m² (odds ratio = 7.74, 95% confidence interval = 2.20-27.27, p = 0.003), and ischemic heart disease (odds ratio, 6.6, 95% confidence interval = 1.62-26.90, p = 0.003), as well as intraoperative parameters—prolonged aortic cross-clamp >84.5 minutes (odds ratio = 3.79, 95% confidence interval = 1.10-13.08, p = 0.03) and cardiopulmonary bypass time >107.5 minutes (odds ratio = 10.0, 95% confidence interval = 1.26-79.58, p = 0.023). Staphylococcus aureus infection (odds ratio = 5.04, 95% confidence interval = 1.29-19.64, p = 0.012), infective endocarditis–related intracardiac complication such as paravalvular abscess detected by transesophageal echocardiography (odds ratio = 4.32, 95% confidence interval = 1.31-14.25, p = 0.01), and infective endocarditis complicated by septic or cardiogenic shock (odds ratio, 18.43, 95% confidence interval = 4.59-73.98, p = 0.001) were statistically significant factors for increased risk of 30-day postoperative mortality. Conclusion: Surgical treatment of infective endocarditis showed good results in our center. The independent predictors of 30-day postoperative mortality for patients who underwent cardiac surgery for infective endocarditis were age, body mass index, ischemic heart disease, prolonged aortic cross-clamp and cardiopulmonary bypass time, Staphylococcus aureus infection, paravalvular abscess, and septic or cardiogenic shock.

scholarly journals 039 * RISK FACTORS FOR POSTOPERATIVE RECURRENCE OF SPONTANEOUS PNEUMOTHORAX TREATED BY VIDEO-ASSISTED THORACOSCOPIC SURGERY

2014 ◽  
Vol 19 (suppl 1) ◽  
pp. S12-S13
Author(s):  
A. Imperatori ◽  
N. Rotolo ◽  
M. Spagnoletti ◽  
L. Festi ◽  
F. Berizzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spontaneous Pneumothorax ◽  
Thoracoscopic Surgery ◽  
Postoperative Recurrence ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Risk factors for conversion to thoracotomy from video-assisted thoracoscopic surgery of lung cancer

2020 ◽  
Vol 3 (4) ◽  
pp. 111-115
Author(s):  
Yifan Liu ◽  
Hao Yu ◽  
Yunzhen Wang ◽  
Zhengfu He
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery
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