title: Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer.
abstract: Few studies have analysed postoperative risk factors in patients undergoing thoracoscopic lobectomy, including assessments of preoperative physical function. The objectives of this study were to identify predictors of postoperative deterioration of performance status and cardiopulmonary complications in cases of thoracoscopic lobectomy.Between June 2005 and October 2012, we retrospectively reviewed 188 consecutive subjects who underwent thoracoscopic lobectomy for preoperative stage I nonsmall cell lung cancer. The demographic and clinical parameters, including physical function, were analysed using a multivariate logistic regression to clarify the determinants.The percent predicted diffusing capacity of the lung for carbon monoxide, quadriceps muscle strength and pathologic stage were independent risk factors for deterioration of performance status after surgery in the multivariate analyses. Chronic obstructive pulmonary disease, 6-min walking distance and pathologic stage were also independent risk factors for postoperative cardiopulmonary complications.Our data suggest that, in addition to a greater pathologic stage, lower diffusing capacity and comorbid chronic obstructive pulmonary disease, poor physical function was associated with worse short-term outcomes after thoracoscopic lobectomy. An evaluation of preoperative quadriceps muscle strength and 6-min walk test is easily performed and may therefore be a useful predictor in cases of thoracoscopic lobectomy.
authors.affiliation: Department of Rehabilitation Medicine, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Kitakyushu, Japan DQL02511@nifty.com.
authors.forename: Masataka
authors.initials: M
authors.lastname: Irie
authors.affiliation: Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Science and Medical School, Nagoya, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Nakanishi
authors.affiliation: Department of Thoracic Surgery, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Kitakyushu, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
authors.affiliation: Department of Rehabilitation Medicine, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Kitakyushu, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Hamada
authors.affiliation: Department of Rehabilitation Medicine, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Kitakyushu, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hyodo
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000150:complications; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000601:surgery*; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011013:Pneumonectomy; D057234:Preoperative Period; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome; D014797:Vital Capacity; D000070857:Walk Test