Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor
Abstract Background In this study, we aimed to summarize the extremely important lesson and experience in the whole process of surgical treatments of lung tumors for the benefit of steps taken to prevent against unplanned reoperation. Methods Demographical and clinical information of 7732 patients w...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-02064-6 |
| _version_ | 1828164612730650624 |
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| author | Long-Yong Mei Yong-Geng Feng Shao-Lin Tao Bin Jiang Fu-Qiang Dai Jing-Hai Zhou Cheng Shen Wei Guo Qun-You Tan Bo Deng |
| author_facet | Long-Yong Mei Yong-Geng Feng Shao-Lin Tao Bin Jiang Fu-Qiang Dai Jing-Hai Zhou Cheng Shen Wei Guo Qun-You Tan Bo Deng |
| author_sort | Long-Yong Mei |
| collection | DOAJ |
| description | Abstract Background In this study, we aimed to summarize the extremely important lesson and experience in the whole process of surgical treatments of lung tumors for the benefit of steps taken to prevent against unplanned reoperation. Methods Demographical and clinical information of 7732 patients were retrospectively retrieved and reviewed, who were diagnosed with pulmonary tumor and underwent surgical treatments from January 2016 to March 2021. Those patients who underwent unplanned reoperation for the treatment of severe complications were focused carefully and analyzed meticulously. Results A total of forty-one patients (41/7732) received 44 unplanned reoperations. Among them, eight and thirty-three patients were diagnosed with benign and malignant tumor, respectively. The incidence of unplanned reoperations seemed to be similar on both sides (Left vs. Right: 12/3231 vs. 29/4501, p = 0.103). Lobectomy plus segmentectomy is prone to reoperation (2/16, 12.5%) as compared to the other types of surgery. The complications leading to reoperation was hemothorax, including active hemorrhage (23/44, 52.3%) and clotted hemothorax (6/44, 13.6%), chylothorax (8/44, 18.2%), and the others (7/44, 15.9%) including bronchopleural fistula, torsion, or injury of right middle bronchus and pulmonary bulla rupture. The morbidity and mortality after unplanned reoperation were 17.1% (7/41) and 12.2% (5/41), respectively. Conclusions Bronchi or vessel stumps, the surgical edges of the lung parenchyma, and pleural adhesions should be checked to avoid postoperative bleeding. Prophylactic ligation of the thoracic duct should be recommended in case of the suspected oily-like exudation in the lymph node bed. Smooth expansion of the middle lobe is important to avoid narrowing and torsion before transection of the bronchus. |
| first_indexed | 2024-04-12T01:29:20Z |
| format | Article |
| id | doaj.art-2f46017148ff4de9b8882fa3d3bc3fab |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-12T01:29:20Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-2f46017148ff4de9b8882fa3d3bc3fab2022-12-22T03:53:32ZengBMCJournal of Cardiothoracic Surgery1749-80902022-12-011711810.1186/s13019-022-02064-6Analysis of the unplanned reoperation following surgical treatment of pulmonary tumorLong-Yong Mei0Yong-Geng Feng1Shao-Lin Tao2Bin Jiang3Fu-Qiang Dai4Jing-Hai Zhou5Cheng Shen6Wei Guo7Qun-You Tan8Bo Deng9Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityThoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical UniversityAbstract Background In this study, we aimed to summarize the extremely important lesson and experience in the whole process of surgical treatments of lung tumors for the benefit of steps taken to prevent against unplanned reoperation. Methods Demographical and clinical information of 7732 patients were retrospectively retrieved and reviewed, who were diagnosed with pulmonary tumor and underwent surgical treatments from January 2016 to March 2021. Those patients who underwent unplanned reoperation for the treatment of severe complications were focused carefully and analyzed meticulously. Results A total of forty-one patients (41/7732) received 44 unplanned reoperations. Among them, eight and thirty-three patients were diagnosed with benign and malignant tumor, respectively. The incidence of unplanned reoperations seemed to be similar on both sides (Left vs. Right: 12/3231 vs. 29/4501, p = 0.103). Lobectomy plus segmentectomy is prone to reoperation (2/16, 12.5%) as compared to the other types of surgery. The complications leading to reoperation was hemothorax, including active hemorrhage (23/44, 52.3%) and clotted hemothorax (6/44, 13.6%), chylothorax (8/44, 18.2%), and the others (7/44, 15.9%) including bronchopleural fistula, torsion, or injury of right middle bronchus and pulmonary bulla rupture. The morbidity and mortality after unplanned reoperation were 17.1% (7/41) and 12.2% (5/41), respectively. Conclusions Bronchi or vessel stumps, the surgical edges of the lung parenchyma, and pleural adhesions should be checked to avoid postoperative bleeding. Prophylactic ligation of the thoracic duct should be recommended in case of the suspected oily-like exudation in the lymph node bed. Smooth expansion of the middle lobe is important to avoid narrowing and torsion before transection of the bronchus.https://doi.org/10.1186/s13019-022-02064-6Thoracic surgeryComplicationsReoperationPulmonary tumor |
| spellingShingle | Long-Yong Mei Yong-Geng Feng Shao-Lin Tao Bin Jiang Fu-Qiang Dai Jing-Hai Zhou Cheng Shen Wei Guo Qun-You Tan Bo Deng Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor Journal of Cardiothoracic Surgery Thoracic surgery Complications Reoperation Pulmonary tumor |
| title | Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor |
| title_full | Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor |
| title_fullStr | Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor |
| title_full_unstemmed | Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor |
| title_short | Analysis of the unplanned reoperation following surgical treatment of pulmonary tumor |
| title_sort | analysis of the unplanned reoperation following surgical treatment of pulmonary tumor |
| topic | Thoracic surgery Complications Reoperation Pulmonary tumor |
| url | https://doi.org/10.1186/s13019-022-02064-6 |
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