Analysis of Risk Factors for Bronchopleural Fistula after Surgical Treatment of Lung Cancer.
PURPOSE
Bronchopleural fistula (BPF) is a potential serious complication of lobectomy or more radical surgery for non-small-cell lung cancer (NSCLC). We aimed to evaluate the risk factors for BPF.


METHODS
The study cohort comprised 635 patients who had undergone lobectomy or more radical surgery for NSCLC from March 2005 to December 2017. We examined the following risk factors for BPF: surgical procedure, medical history, preoperative treatment, and surgical management.


RESULTS
In all, 10 patients (1.6%) had developed postoperative BPFs. Univariate logistic regression analysis showed that surgical procedure, medical history (arteriosclerosis obliterans [ASO]), and bronchial stump reinforcement were significant risk factors. Multivariate analysis showed that only surgical procedure (right lower lobectomy, p = 0.011, odds ratio = 17.4; right middle lower lobectomy, p = 0.003, odds ratio = 59.4; right pneumonectomy, p <0.001, odds ratio = 166.0) was a significant risk factor. Multivariate analysis confined to the surgical procedure of lobectomy showed that right lower lobectomy (p = 0.011, odds ratio = 36.5) and diabetes (HbA1c ≥8.0) (p = 0.022, odds ratio = 31.7) were significant risk factors.


CONCLUSION
When lobectomy or more radical surgery is performed for NSCLC, right lower lobectomy, middle lower lobectomy, and right pneumonectomy are significant risk factors for postoperative BPF. Thoracic surgeons should acquire the techniques of bronchoplasty and angioplasty to avoid such invasive procedures.
['Tokunaga|Yoshimasa|Y|', 'Kita|Yusuke|Y|', 'Okamoto|Taku|T|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001983:Bronchial Fistula D002289:Carcinoma, Non-Small-Cell Lung D005260:Female D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D010995:Pleural Diseases D011013:Pneumonectomy D016156:Respiratory Tract Fistula D018570:Risk Assessment D012307:Risk Factors D016896:Treatment Outcome D055815:Young Adult
risk factors bronchopleural fistula lung cancer