Background: Pulmonary metastasectomy (PM) is a widely accepted surgical procedure. This study aims to investigate postoperative morbidity and mortality after PM and develop a score to predict high-risk patients. Methods: We retrospectively investigated all patients undergoing a PM in our institution from November 2012 to January 2023. Complications were defined as the diagnosis of any new disease after the PM up to 30 days after the operation. Results: 1284 patients were identified. At least one complication occurred in 145 patients (11.29%). Only one patient died during the hospital stay. Preoperative cardiovascular comorbidities (OR: 2.99, 95% CI: 1.412–3.744,p= 0.01), major lung resections (OR: 2.727, 95% CI: 1.678–4.431,p< 0.01), repeated pulmonary metastasectomy (OR: 1.759, 95% CI: 1.040–2.976,p= 0.03) and open thoracotomy (OR: 0.621, 95% CI: 0.415–0.930,p= 0.02) were identified as independent factors for postoperative complications. Based on the above independent factors for postoperative morbidity, the Essen score was developed (overall correct classification: 94.6%, ROC-Analysis: 0.828, 95% CI: 0.795–0.903). Conclusion: PM is a safe surgical procedure with acceptable morbidity and low mortality. The aim of the Essen score is to identify patients that are associated with risk for postoperative complications after PM.
背景：肺转移瘤切除术（PM）是一种被广泛接受的外科手术。本研究旨在探讨PM术后并发症发生率及死亡率，并开发一种评分系统以预测高风险患者。方法：我们回顾性分析了2012年11月至2023年1月期间在本机构接受PM的所有患者。并发症定义为术后30天内出现的任何新发疾病。结果：共纳入1284例患者。145例患者（11.29%）至少发生一种并发症。仅1例患者在住院期间死亡。术前心血管合并症（OR：2.99，95% CI：1.412–3.744，p=0.01）、主要肺切除术（OR：2.727，95% CI：1.678–4.431，p<0.01）、重复肺转移瘤切除术（OR：1.759，95% CI：1.040–2.976，p=0.03）以及开胸手术（OR：0.621，95% CI：0.415–0.930，p=0.02）被确定为术后并发症的独立影响因素。基于上述术后并发症的独立影响因素，我们开发了埃森评分（总体正确分类率：94.6%，ROC分析：0.828，95% CI：0.795–0.903）。结论：PM是一种安全的外科手术，并发症发生率可接受且死亡率低。埃森评分旨在识别与PM术后并发症风险相关的患者。
肿瘤(癌症)患者之家