title: Wedge resection for localized infectious lesions: high margin/lesion ratio guaranteed operational safety.
abstract: OBJECTIVE
  This study aims to elucidate the risk factors of pulmonary complications for localized infectious lesions with limited resection.
  
  
  METHODS
  We retrospectively investigated 139 cases for which wedge resection had been performed for localized pulmonary infectious lesions. Patients included 85 males and 54 females with a median age of 53 years (range: 21-74 years old). Forty-six patients had focal organizing pneumonia (OP), sixty patients had lung abscess, twenty-three patients had aspergilloma, five patients had lung abscess combining aspergillus fumigatus, and five patients had lung abscess combined with tuberculosis granuloma. Information regarding perioperative manipulations, surgical complications, and follow-ups were collected for further analysis.
  
  
  RESULTS
  Prominent pneumonia developed in eight cases post-operation. In follow-up, one patient had a recurrence of lung abscess five months post-operation and underwent a left upper lobectomy and one patient died two months after discharge because of respiratory failure that resulted from pneumonia. Univariate and multivariate analysis showed a significant difference in the margin/lesion ratio (distance between staple margins to lesion/the maximum tumor diameter) between patients with pulmonary complications and those without complications (P=0.01). The best cut-off value of margin/lesion ratio to complication was 0.985, and a margin/lesion ratio less than 0.985 was associated with high post-operative complications.
  
  
  CONCLUSIONS
  The present case series shows that partial resection for localized pulmonary infection is an acceptable surgical manipulation. A high margin/lesion ratio achievement may guarantee operational safety.
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Sun
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Likun
authors.initials: L
authors.lastname: Hou
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Huikang
authors.initials: H
authors.lastname: Xie
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zheng
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Gening
authors.initials: G
authors.lastname: Jiang
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Gao
authors.affiliation: 1 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Chen
keywords: Wedge resection; complication; infectious lesions; lung; operation