Risk factors postoperative diaphragmatic dysfunction in video-assisted thoracic surgery patients: a dynamic digital...

Area of Science:

• Thoracic Surgery
• Respiratory Medicine
• Medical Imaging

Background:

• Postoperative diaphragmatic dysfunction (DD) is a common complication after thoracic surgery, impacting recovery.
• Video-assisted thoracic surgery (VATS) is a minimally invasive approach, but DD remains a concern.
• Dynamic digital radiography (DDR) can quantitatively assess diaphragmatic excursion, but its role in VATS-related DD is underexplored.

Purpose of the Study:

• To identify factors associated with postoperative diaphragmatic dysfunction (DD) in patients undergoing video-assisted thoracic surgery (VATS).
• To explore the utility of dynamic digital radiography (DDR) in assessing DD risk factors post-VATS.

Main Methods:

• Retrospective study of 190 patients undergoing VATS.
• DD defined by diaphragmatic excursion thresholds on DDR.
• Demographic, clinical, surgical, pulmonary function, and imaging data collected.
• Univariate and multivariate logistic regression analyses performed to identify risk factors.

Main Results:

• 121 patients (63.68%) developed DD.
• Independent risk factors included longer length of stay (LOS), reduced diaphragmatic motion amplitude during quiet breathing (LDA-QB, RDA-QB).
• Increased diaphragmatic motion amplitude during forced breathing (LDA-FB, RDA-FB) was associated with reduced DD risk.

Conclusions:

• Reduced diaphragmatic excursion measured by DDR is independently associated with postoperative DD after VATS.
• Early identification of patients with reduced excursion may allow for targeted respiratory rehabilitation.
• Findings require confirmation in prospective studies.