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Related Experiment Video

Updated: Jan 27, 2026

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Refined risk stratification for thoracoscopic lobectomy or segmentectomy.

Ruoyu Zhang1,2, Jürgen Dippon3, Godehard Friedel2

  • 1Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Giessen, Germany.

Journal of Thoracic Disease
|March 14, 2019
PubMed
Summary

The American Society of Anesthesiologists physical status (ASA-PS) score reliably predicts complications after thoracoscopic lobectomy for lung cancer. This easily assessed factor can enhance current risk stratification models for improved patient outcomes.

Keywords:
American Society of Anesthesiologists physical status (ASA-PS)Risk assessmentlung resectionminimally invasive thoracic surgeryoutcomes

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Anesthesiology

Background:

  • Wide adoption of thoracoscopic lobectomy necessitates re-evaluation of existing risk assessment models.
  • Previous models may not fully capture risks associated with minimally invasive lung resections.

Purpose of the Study:

  • To assess the reliability of established predictors for postoperative complications in patients undergoing thoracoscopic lobectomy.
  • To determine the validity of current risk assessment tools in the context of minimally invasive lung surgery.

Main Methods:

  • Analysis of 606 patients undergoing thoracoscopic lobectomy or segmentectomy from 2009-2017.
  • Logistic regression and causal inference analyses (propensity score weighting) to identify complication predictors.

Main Results:

  • Postoperative mortality: 1.0%, pulmonary complications: 8.9%, cardiovascular complications: 5.8%, overall morbidity: 18.0%.
  • American Society of Anesthesiologists physical status (ASA-PS) grade 3 or 4 significantly increased odds of cardiopulmonary (OR=2.116) and overall morbidity (OR=1.740) compared to grades 1 or 2.
  • Lung function determinants showed only slight association with overall morbidity.

Conclusions:

  • Current physiologic evaluation algorithms are applicable to thoracoscopic lung resections.
  • ASA-PS is a valuable, easily assessable predictor of major complications after thoracoscopic lobectomy.
  • Incorporating ASA-PS into existing algorithms can improve risk stratification for thoracoscopic lung surgery.