1. Concomitant Mediastinoscopy Increases the Risk of Postoperative Pneumonia After Pulmonary Lobectomy
- Author
-
Sai Yendamuri, Grace K. Dy, Anthony Picone, Mark Hennon, Elisabeth U. Dexter, Kris Attwood, Chukwumere Nwogu, Samjot Singh Dhillon, Todd L. Demmy, and Athar Battoo
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,VATS lobectomy ,030204 cardiovascular system & hematology ,Article ,Mediastinoscopy ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,Humans ,Medicine ,Pneumonectomy ,Lung cancer ,Aged ,Retrospective Studies ,Univariate analysis ,medicine.diagnostic_test ,Thoracic Surgery, Video-Assisted ,business.industry ,Retrospective cohort study ,Pneumonia ,Odds ratio ,Middle Aged ,medicine.disease ,Surgery ,Oncology ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Concomitant ,Female ,business - Abstract
Mediastinoscopy is considered the gold standard for preresectional staging of lung cancer. We sought to examine the effect of concomitant mediastinoscopy on postoperative pneumonia (POP) in patients undergoing lobectomy. All patients in our institutional database (2008โ2015) undergoing lobectomy who did not receive neoadjuvant therapy were included in our study. The relationship between mediastinoscopy and POP was examined using univariate (Chi square) and multivariate analyses (binary logistic regression). In order to validate our institutional findings, lobectomy data in the National Surgical Quality Improvement Program (NSQIP) from 2005 to 2014 were analyzed for these associations. Of 810 patients who underwent a lobectomy at our institution, 741 (91.5%) surgeries were performed by video-assisted thoracic surgery (VATS) and 487 (60.1%) patients underwent concomitant mediastinoscopy. Univariate analysis demonstrated an association between mediastinoscopy and POP in patients undergoing VATS [odds ratio (OR) 1.80; p = 0.003], but not open lobectomy. Multivariate analysis retained mediastinoscopy as a variable, although the relationship showed only a trend (OR 1.64; p = 0.1). In the NSQIP cohort (N = 12,562), concomitant mediastinoscopy was performed in 9.0% of patients, with 44.5% of all the lobectomies performed by VATS. Mediastinoscopy was associated with POP in patients having both open (OR1.69; p
- Published
- 2018
- Full Text
- View/download PDF