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. 2022 Oct;14(10):3811-3818.
doi: 10.21037/jtd-22-798.

Impact of previous upper gastrointestinal cancer surgery on complications after lobectomy for lung cancer

Takashi Yamamichi  1 , Junji Ichinose  1 , Satoru Tamagawa  1 , Kohei Hashimoto  1 , Yosuke Matsuura  1 , Masayuki Nakao  1 , Sakae Okumura  1 , Mingyon Mun  1
Affiliations

Impact of previous upper gastrointestinal cancer surgery on complications after lobectomy for lung cancer

Takashi Yamamichi et al. J Thorac Dis. 2022 Oct.

Abstract

Background: The number of lung cancer patients with a history of other malignancies is increasing. Previous upper gastrointestinal cancer (UGIC) surgery may increase the risk of complications after lung cancer surgery due to malnutrition and susceptibility in patients; therefore, we investigated its short-term outcomes.

Methods: We retrospectively examined patients with lung cancer who underwent thoracoscopic lobectomy between 2011 and 2021 and collected data regarding postoperative complications and postoperative pulmonary complications ≥ grade II of the Clavien-Dindo classification that developed within 3 months post-surgery. The effect of UGIC surgery on the postoperative complications was evaluated by multivariable analysis using logistic regression.

Results: Among the 1,385 included patients, 377 patients had a history of cancer surgery and 65 (4.7%) of them had undergone UGIC surgery. Postoperative and pulmonary complications were observed in 155 (11.2%) and 39 (2.9%) patients, respectively. The frequency of pulmonary complications was significantly higher in patients with previous UGIC surgery (9.2% vs. 2.5%, P=0.003) with no significant difference in all complications (16.9% vs. 10.9%, P=0.137). Multivariable analysis showed that previous UGIC surgery is an independent factor associated with postoperative pulmonary complications (odds ratio =2.923, P=0.029). In contrast, previous surgery for cancer other than UGIC was not associated with postoperative pulmonary complications (the rate was 1.2% after lower gastrointestinal cancer surgery and 3.0% after non-gastrointestinal cancer surgery).

Conclusions: Previous UGIC surgery was an independent factor associated with postoperative pulmonary complications after lung cancer surgery.

Keywords: Postoperative pulmonary complication; lung cancer; thoracoscopic surgery; upper gastrointestinal cancer surgery (UGIC surgery).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-798/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of the patients included in the study.
Figure 2
Figure 2
Details of postoperative pulmonary complications with some overlapping. IPF, idiopathic pulmonary fibrosis; UGIC, upper gastrointestinal cancer.
See this image and copyright information in PMC

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