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Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis.

Publication ,  Journal Article
Linden, PA; Block, MI; Perry, Y; Gaissert, HA; Worrell, SJ; Grau-Sepulveda, MV; Kosinski, AS; Jawitz, OK; Hartwig, MG; Towe, CW
Published in: Ann Thorac Surg
November 2022

BACKGROUND: The perioperative risk of pulmonary lobectomy as a solitary procedure has been extensively studied, yet the differences in outcomes between lobes, which have unique anatomy and a different amount of lung parenchyma, are entirely unknown. The purpose of this study was to define the risk of each of the 5 lobectomies. METHODS: The Society of Thoracic Surgeons Database was queried for patients undergoing lobectomy between 2008 and 2018. Patient and disease characteristics, operative variables, major morbidity, and 30-day mortality were examined. A multivariable logistic regression model (using the same variables in the current Society of Thoracic Surgeons lobectomy risk model) was developed to assess the contribution of lobectomy site to adverse outcomes. RESULTS: There were 65 006 patients analyzed. Adjusted perioperative mortality rate is lowest for right middle lobe (RML), 0.63%; intermediate for right upper lobe (RUL), left upper lobe (LUL), and left lower lobe (LLL), 1.08 to 1.24%; and highest for right lower lobe (RLL), 1.63%. The adjusted major morbidity rate is lowest for RML, 5.36%; intermediate for LLL and LUL, 7.82% to 8.33%; and highest for RUL and RLL, 8.94% to 9.32%. Adjusted intraoperative transfusion rate is lowest for RML, 1.37%; intermediate for RLL and LLL, 1.81% to 1.94%; and highest for RUL and LUL, 2.47% to 2.72%. CONCLUSIONS: There are clear differences in postoperative outcomes by lobectomy location. Mortality, major morbidity, and transfusion rate are lowest for RML but vary across other lobectomies. These differences should be appreciated in evaluating risk of operation, deciding on best therapy, counseling patients, and comparing outcomes.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

November 2022

Volume

114

Issue

5

Start / End Page

1871 / 1877

Location

Netherlands

Related Subject Headings

  • Thoracic Surgery, Video-Assisted
  • Surgeons
  • Retrospective Studies
  • Respiratory System
  • Pneumonectomy
  • Lung Neoplasms
  • Lung
  • Humans
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Linden, P. A., Block, M. I., Perry, Y., Gaissert, H. A., Worrell, S. J., Grau-Sepulveda, M. V., … Towe, C. W. (2022). Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis. Ann Thorac Surg, 114(5), 1871–1877. https://doi.org/10.1016/j.athoracsur.2022.03.012
Linden, Philip A., Mark I. Block, Yaron Perry, Henning A. Gaissert, Stephanie J. Worrell, Maria V. Grau-Sepulveda, Andrzej S. Kosinski, Oliver K. Jawitz, Matthew G. Hartwig, and Christopher W. Towe. “Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis.Ann Thorac Surg 114, no. 5 (November 2022): 1871–77. https://doi.org/10.1016/j.athoracsur.2022.03.012.
Linden PA, Block MI, Perry Y, Gaissert HA, Worrell SJ, Grau-Sepulveda MV, et al. Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis. Ann Thorac Surg. 2022 Nov;114(5):1871–7.
Linden, Philip A., et al. “Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis.Ann Thorac Surg, vol. 114, no. 5, Nov. 2022, pp. 1871–77. Pubmed, doi:10.1016/j.athoracsur.2022.03.012.
Linden PA, Block MI, Perry Y, Gaissert HA, Worrell SJ, Grau-Sepulveda MV, Kosinski AS, Jawitz OK, Hartwig MG, Towe CW. Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis. Ann Thorac Surg. 2022 Nov;114(5):1871–1877.

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

November 2022

Volume

114

Issue

5

Start / End Page

1871 / 1877

Location

Netherlands

Related Subject Headings

  • Thoracic Surgery, Video-Assisted
  • Surgeons
  • Retrospective Studies
  • Respiratory System
  • Pneumonectomy
  • Lung Neoplasms
  • Lung
  • Humans
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology