Synapse - Operative time is associated with postoperative complications after pulmonary lobectomy

Operative time is associated with postoperative complications after pulmonary lobectomy Journal Article

Authors:	de Angelis, P.; Tan, K. S.; Chudgar, N. P.; Dycoco, J.; Adusumilli, P. S.; Bains, M. S.; Bott, M. J.; Downey, R. J.; Huang, J.; Isbell, J. M.; Molena, D.; Park, B. J.; Rusch, V. W.; Sihag, S.; Jones, D. R.; Rocco, G.
Article Title:	Operative time is associated with postoperative complications after pulmonary lobectomy
Abstract:	Objective: To investigate the association between operative time and postoperative outcomes. Background: The association between operative time and morbidity after pulmonary lobectomy has not been characterized fully. Methods: Patients who underwent pulmonary lobectomy for primary lung cancer at our institution from 2010 to 2018 were reviewed. Exclusion criteria included clinical stage >= IIb disease, conversion to thoracotomy, and previous ipsilateral lung treatment. Operative time was measured from incision to closure. Relationships between operative time and outcomes were quantified using multivariable mixed-effects models with surgeon-level random effects. Results: In total, 1651 patients were included. The median age was 68 years (interquartile range, 61-74), and 63% of patients were women. Median operative time was 3.2 hours (interquartile range, 2.7-3.8) for all cases, 3.0 hours for open procedures, 3.3 hours for video-assisted thoracoscopies, and 3.3 hours for robotic procedures (P=0.0002). Overall, 488 patients (30%) experienced a complication; 77 patients (5%) had a major complication (grade >= 3), and 5 patients (0.3%) died within 30 days of discharge. On multivariable analysis, operative time was associated with higher odds of any complication [odds ratio per hour, 1.37; 95% confidence interval (CI), 1.20-1.57; P<0.0001] and major complication (odds ratio per hour, 1.41; 95% CI, 1.21-1.64; P<0.0001). Operative time was also associated with longer hospital length of stay (beta, 1.09; 95% CI, 1.04-1.14; P=0.001). Conclusions: Longer operative time was associated with worse outcomes in patients who underwent lobectomy. Operative time is a potential risk factor to consider in the perioperative phase.
Keywords:	mortality; lung resection; morbidity; lung cancer; resident; risk-factors; assisted thoracic-surgery; thoracoscopic lobectomy; operative time; cancer; pulmonary lobectomy
Journal Title:	Annals of Surgery
Volume:	278
Issue:	6
ISSN:	0003-4932
Publisher:	Lippincott Williams & Wilkins
Date Published:	2023-12-01
Start Page:	e1259
End Page:	e1266
Language:	English
ACCESSION:	WOS:001162552900018
DOI:	10.1097/sla.0000000000005696
PROVIDER:	wos
PMCID:	PMC9985664
PUBMED:	36066195
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Gaetano Rocco -- Source: Wos