Predictors of reoperation after lung volume reduction surgery

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Complications

Background:

• Lung volume reduction surgery (LVRS) effectively treats emphysema by improving lung function and reducing symptoms.
• Postoperative air leaks are a significant complication of LVRS, frequently necessitating reoperation.

Purpose of the Study:

• To analyze reoperations following LVRS and identify potential predictors.
• To understand the causes and outcomes of reoperations after LVRS.

Main Methods:

• A single-center, consecutive series of unilateral VATS LVRS procedures from 2017-2022 were reviewed.
• Multivariable logistic regression analysis was employed to identify predictors of reoperation.
• Data on reoperation indications, injury locations, length of stay, and mortality were collected and analyzed.

Main Results:

• 13% of 191 patients (25) required reoperation, primarily for substantial air leaks (21 patients).
• Reoperation was associated with a significantly prolonged length of stay (21 vs. 5 days) and increased 30-day mortality.
• Lower diffusing capacity for carbon monoxide (DLCO) and single-lobe resections were identified as significant predictors of reoperation.

Conclusions:

• The incidence of reoperation after LVRS was 13%, leading to extended hospital stays and higher 30-day mortality.
• Low DLCO and single-lobe resections are significant predictors for reoperation after LVRS.
• Air leaks causing reoperation were typically not located along the stapler line.