Surgical Interval as a Risk Factor for Postoperative Complications After Repeated Lung Cancer Resection: A...

With improved survival after initial surgery, repeated pulmonary resections are increasingly performed. However, the clinical effect of the interval between operations remains unclear.

This study retrospectively analyzed data from patients who underwent only contralateral repeated pulmonary resection for lung cancer at a single institution between 2002 and 2024, assessing 30-day postoperative complications. Surgical interval was categorized as ≤3 months and >3 months. Multivariable logistic regression was employed to identify risk factors for morbidity.

The final cohort comprised 246 contralateral second resections in 123 patients. The mean surgical interval was 40.2 months (median, 27 months). Approximately 40% of second resections occurred within 12 months of the first, half of which were within 3 months. Postoperative complications developed in 25 (20.3%; n = 25/123) patients who were frequently male, had a lower body mass index, and more commonly underwent anatomic resection. Multivariable analysis revealed age (odds ratio [OR], 1.15; 95% CI, 1.04-1.28), male sex (OR, 0.09; 95% CI, 0.02-0.40), anatomic resection (OR, 11.0; 95% CI, 2.08-58.3), and ≤3-month surgical interval (OR, 3.36; 95% CI, 1.01-11.3) as independently associated with postoperative complications. The overall morbidity rate was significantly higher in patients with a ≤3-month interval compared with longer intervals (36.0% [n = 9/25] vs 16.3% [n = 16/98]; P = .029).

Contralateral repeated pulmonary resection is feasible, but a ≤3-month surgical interval is associated with greater postoperative morbidity. The surgical interval should be considered an important factor in operative planning.