Cardiothoracic Surgery |

Effects of Pulmonary Function and of Smoking History on Perioperative Outcomes After Robotic-Assisted Pulmonary Lobectomy: Retrospective Analysis of 201 Consecutive Patients FREE TO VIEW

Kathryn Rodriguez, BS; Frank Velez-Cubian, MD; Wei Wei Zhang, MD; Tawee Tanvetyanon, MD; Matthew Thau, BS; Carla Moodie, PA-C; Joseph Garrett, ARNP-C; Jacques-Pierre Fontaine, MD; Lary Robinson, MD; Eric Toloza, MD
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Moffitt Cancer Center, Tampa, FL

Chest. 2014;145(3_MeetingAbstracts):48A. doi:10.1378/chest.1836680
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SESSION TITLE: Thoracic Surgery Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Poor pulmonary function tests have been shown to be predictors of respiratory complications after lung resection via thoracotomy. Expanding surgical options to lung cancer patients with marginal pulmonary function must be balanced with maintaining patient safety. We sought to determine the role of forced expired volume in one second (FEV1), diffusion capacity to carbon monoxide (DLCO), arterial blood gas (ABG) partial pressures of carbon dioxide and of oxygen (PaCO2, PaO2), smoking status, and smoking history in predicting respiratory complications after robotic-assisted pulmonary lobectomy.

METHODS: We retrospectively analyzed the smoking status, pack-year smoking history, preoperative pulmonary function tests and room-air arterial blood gases, and postoperative respiratory complications of 201 consecutive patients who underwent robotic-assisted pulmonary lobectomy at our institution over 33 months. Student’s t-tests determined differences between patients with and without respiratory complications. Logistic regressions determined whether any observed variables were significant predictors of respiratory complications.

RESULTS: In 201 patients who underwent robotic-assisted pulmonary lobectomy, a total of 63 (31%) respiratory complications occurred. Patients with respiratory complications (mean age = 68.9 yr; mean BMI = 28.0 kg/m2) were compared to those without respiratory complications (mean age = 65.6 yr; mean BMI = 27.8 kg/m2). There was no significant difference (p>0.05) in smoking status (current versus former versus never) between patients who had respiratory complications versus those without respiratory complications. Logistic regression revealed that preoperative FEV1 (%), DLCO (%), PaCO2 (mmHg), and PaO2 (mmHg) were not significant predictors of respiratory complications (p>0.05). However, pack-year smoking history was found to correlate with respiratory complications (p<0.001).

CONCLUSIONS: Respiratory complications after robotic-assisted pulmonary lobectomy are not associated with smoker status, decreased preoperative pulmonary function tests, or decreased preoperative arterial blood gases. In contrast, pack-year smoking history does correlate with respiratory complications after robotic-assisted lobectomy.

CLINICAL IMPLICATIONS: Patients who undergo robotic-assisted pulmonary lobectomy and who are current smokers should undergo even more aggressive pulmonary toilet than routinely provided in the postoperative period.

DISCLOSURE: Eric Toloza: Other: Honoraria for proctoring & observation site The following authors have nothing to disclose: Kathryn Rodriguez, Frank Velez-Cubian, Wei Wei Zhang, Tawee Tanvetyanon, Matthew Thau, Carla Moodie, Joseph Garrett, Jacques-Pierre Fontaine, Lary Robinson

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