在新辅助免疫疗法后,肺癌的手术挑战和术后并发症
Guangyu Bai1, Xiaowei Chen1, Yue Peng2
1Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
肺癌的新辅助化疗免疫疗法可能会增加手术困难,但可以控制术后并发症. 建议减少开放性手术转换和肺切除术的策略,以获得更好的患者结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 有限的现实世界数据存在于中国肺癌的新辅助免疫治疗后的手术挑战和并发症.
- 新辅助免疫疗法越来越多地用于肺癌,需要了解其手术影响.
研究的目的:
- 分析新辅助免疫疗法治疗肺癌患者的手术困难和术后并发症.
- 确定与具有挑战性的手术和严重的术后并发症相关的风险因素.
主要方法:
- 从2018年1月到2023年1月对261名肺癌患者的回顾性分析.
- 手术困难按持续时间分类;并发症按克拉维恩-丁多系统分级.
- 后勤回归用于确定手术持续时间和并发症的风险因素.
主要成果:
- 43.7%的手术被归类为具有挑战性;整体术后并发症率为22.2%.
- 具有挑战性的手术的独立风险因素包括吸烟史,化学免疫疗法和转换为开放手术.
- 肺切除术是具有挑战性的手术的保护因素,但也是并发症的风险因素;具有挑战性的手术也增加了并发症风险.
结论:
- 新辅助化学免疫疗法可以增加手术困难,但术后并发症仍然是可以接受的.
- 在肺癌新辅助免疫治疗后,尽量减少对开放性手术和肺切除术的转换至关重要.
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