International Journal of Medical Sciences

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23 January 2019

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Int J Med Sci 2014; 11(9):863-869. doi:10.7150/ijms.8912

Research Paper

Risk Factors for Major Adverse Events of Video-Assisted Thoracic Surgery Lobectomy for Lung Cancer

Jie Yang*, Yan Xia*, Yang Yang, Zheng-zheng Ni, Wen-xin He, Hai-feng Wang, Xiao-xiong Xu, Yu-ling Yang, Ke Fei, Ge-ning Jiang

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China
* Dr. Jie Yang and Yan Xia contribute equally to this work.


Aims: The purpose of this study was to identify the risk factors for major adverse events of VATS (Video-Assisted Thoracic Surgery) lobectomy for primary lung cancer.

Methods: 1806 Patients (1032 males, 57.1%) planned to undergo VATS lobectomy for stage IA-IIIA lung cancer from July 2007 to June 2012. The Thoracic Morbidity and Mortality Classification TM&M system was used to evaluate the presence and severity of complications. Postoperative complications were observed during a 30-day follow up. Univariate and multivariate analysis were used to analyze the independent risk factors for major adverse events.

Results: Successful rate of VATS lobectomy was 97.6% (1763/1806). Major complications occurred in 129 patients (7.3%), with a mortality of 0.3% (5/1763). Pulmonary complications contribute up to 90.7% of the major complications and 80% of mortality. Logistic regression indicated that comorbidities, elder age ≥70y, operative time ≥240min and hybrid VATS were predictors for major adverse events (P<0.05). Hybrid and converted VATS lobectomy result in higher major adverse events compared with complete VATS, 15.1%, 20.9% and 7.4% respectively (P=0.013).

Conclusions: The overall complication rate and mortality of VATS lobectomy are low, while major complications sometimes occur. Pulmonary complications are the most common major complications and cause of mortality. Age ≥70y, comorbidities, operative time ≥240min and Hybrid VATS are predictors of major adverse events.

Keywords: Non-small cell lung cancer, VATS, Lobectomy, Major Adverse Events, Risk factor

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Yang J, Xia Y, Yang Y, Ni Zz, He Wx, Wang Hf, Xu Xx, Yang Yl, Fei K, Jiang Gn. Risk Factors for Major Adverse Events of Video-Assisted Thoracic Surgery Lobectomy for Lung Cancer. Int J Med Sci 2014; 11(9):863-869. doi:10.7150/ijms.8912. Available from