接受亚肺叶切除的肺癌患者住院时间延长的预测因素

Predictors of prolonged hospital stay in patients with lung cancer undergoing sublobar resection.

期刊: Translational Lung Cancer Research
PMID: 42582870
原文: PubMed ↗
发布日期: 2026-08-12

作者

Liang Xia — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Xiaohu Hao — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Ruichen Cui — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Jiahan Cheng — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Minzhang Guo — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Wenjing Zhou — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Shasha Li — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Qiang Pu — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.
Yunke Zhu — Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.

作者单位

Department of Thoracic Surgery and Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, China.

摘要

中文

亚肺叶切除（SLR）已成为外周型早期非小细胞肺癌（NSCLC）患者的标准治疗。识别导致SLR后住院时间（LOS）延长的危险因素对于提高手术服务效率至关重要。本研究旨在识别接受SLR的NSCLC患者中LOS延长的预测因素。这项回顾性研究纳入了2011年至2021年在华西医院连续接受SLR的NSCLC患者。主要结局是临床病理因素与延长LOS（定义为超过中位LOS）之间的关联。采用多变量逻辑回归分析来识别LOS延长的预测因素。总体而言，研究纳入了4,173名患者（楔形切除：n=1,287；肺段切除：n=2,886）。楔形切除组和肺段切除组的中位术后LOS分别为3天和4天。高龄、男性、就诊时有症状、主病灶较大和手术时间较长在楔形切除组和肺段切除组中均与LOS延长显著相关。较高的第1秒用力呼气容积占预计值百分比是SLR后LOS延长的保护因素，而较高的肺一氧化碳弥散量占预计值百分比则专门是肺段切除的保护因素。男性、高龄、就诊时有症状、主病灶较大、手术时间较长和肺功能受损是SLR后LOS延长的危险因素。具有这些危险因素的SLR候选者在临床规划和术后管理中需要高度关注。

English

Sublobar resection (SLR) has become the standard treatment for patients with peripheral early-stage non-small cell lung cancer (NSCLC). Identifying the risk factors contributing to prolonged length of stay (LOS) after SLR is critical to improving surgical service efficiency. This study aimed to identify the predictors of prolonged LOS in patients with NSCLC who have undergone SLR. This retrospective study included consecutive patients with NSCLC who underwent SLR between 2011 and 2021 at West China Hospital. The primary outcome was the association between clinicopathological factors and prolonged LOS (defined as an LOS exceeding the median LOS). Multivariate logistic regression analysis was performed to identify the predictors of prolonged LOS. Overall, 4,173 patients were included in the study (wedge resection: n=1,287; segmentectomy: n=2,886). The median postoperative LOS was 3 and 4 days in the wedge resection and segmentectomy groups, respectively. Advanced age, male sex, symptoms at presentation, larger size of the main lesion, and longer operative time were significantly associated with prolonged LOS in both the wedge and segmentectomy groups. A higher percent predicted forced expiratory volume in the first second was a protective factor for prolonged LOS after SLR, whereas a higher percent predicted diffusion capacity for carbon monoxide was a protective factor specifically for segmentectomy. Male sex, advanced age, symptoms at presentation, larger main lesion size, longer operative time, and impaired lung function were risk factors for a prolonged LOS after SLR. Candidates for SLR with these risk factors require heightened attention during clinical planning and postoperative management.

分类与指标

研究类型: 临床研究
病种: 肺癌
JCR 分区: Q2
影响因子: 3.4
新锐分区: 3区