Effect Of Different Methods For Lung Isolation On Postoperative Pulmonary Complications In Patients With Lung Cancer

Part One Effect of different methods for lung isolation on postoperative pulmonary complications in patients with lung cancer: a retr-ospective cohort studyObjective: To investigate the association between the different methods for lung isolation and postoperative pulmonary complications(PPCs)in patients with lung cancer.Methods: In this retrospective cohort study,patients who underwent lung cancer surgery between January 1,2020 and October 31,2020 were screened.Patients were divided into two groups according to different devices for lung isolation: DLT group and BB group.Primary outcome was the incidence of a composite of PPCs during postoperative in-hospital stay.Results: A total of 1721 were enrolled for analysis,of them,868 received DLT and 853 BB.When adjusted for PPCs confounders,a composite of PPCs was less common in patients with BB(25.1%,[214/853])than those received DLT(37.9% [329/868],OR 0.614,95% CI 0.451-0.836,P<0.001).Respiratory infection was less common in BB group(14.4%,[123/853])than DLT group(30.3%,[263/868],P<0.001).The incidence of non-PPCs complications was not statistically significant between the 2 groups(P>0.05).Conclusions: For patients undergoing surgery for lung cancer,the use of BB for lung isolation was associated with a reduced risk of PPCs when compared with DLT.Part Two Effect of different methods for lung isolation on postoperative pulmonary complications in elderly patients with lung can-cer: a multicenter propensity score-matched analysisObjective: To investigate the association between the different methods for lung isolation and postoperative pulmonary complications(PPCs)in elderly patients with lung cancer.Methods: In this retrospective cohort study,elderly patients who underwent lung cancer surgery from January 1,2017 to October 31,2020 in the Forth hospital of Hebei Medical University and Peking University First Hospital were screened according to the inclusion and exclusion criteria.Preoperative data,surgical data,anesthesia data and postoperative data were collected from the electronic medical record system.Patients were divided into two groups according to different methods for lung isolation used during operation: DLT group and BB group.After a 1-to-1 propensity score-matched analysis,the incidence of a composite of PPCs and other complications during hospitalization was compared between the two groups.Results: A total of 1758 were enrolled for analysis,of them,1107 received DLT and 853 BB.There were 571 patients in each group after propensity score matching.The incidence of PPCs in DLT group and BB group were 38.4% and28.2%,and the difference between the 2 groups was statistically significant(RR=0.735,95%CI 0.622-0.869,P<0.001).Compared with DLT group,the incidence of postoperative pneumonia(23.6% vs 16.5%,RR=0.696,95%CI0.550-0.862,P=0.002)and pleural effusion(16.6% vs 11.0%,RR=0.663,95%CI 0.493-0.892,P=0.006)were lower in BB group.There were no significant differences in the incidence of postoperative respiratory failure,atelectasis,bronchospasm,other non-PPCs complications and unplanned ICU admission between the 2 groups.Conclusions: For elderly patients undergoing surgery for lung cancer,the use of BB for lung isolation was associated with a reduced risk of PPCs when compared with DLT.