Concomitant Mediastinoscopy Increases the Risk of Postoperative Pneumonia After Pulmonary Lobectomy

Abstract

Mediastinoscopy may be associated with an increased risk of POP after pulmonary lobectomy. This observation should be examined in other datasets as it potentially impacts preresectional staging algorithms for patients with lung cancer.

An External-Validated Algorithm to Predict Postoperative Pneumonia Among Elderly Patients With Lung Cancer After Video-Assisted Thoracoscopic Surgery

“…The present study showed that male sex, longer surgery duration, higher leukocyte count, larger intraoperative use of colloid, and intraoperative use of hormones were significantly associated with a higher rate of developing postoperative pneumonia especially among elder patients with lung cancer after video-assisted thoracoscopic surgery. Of the five significant variables identified by the LASSO method, two of them, i.e., male sex and longer surgery duration, were previously confirmed by other studies ( 22 , 25 , 26 , 33 ). Since smoking status and history of COPD were previously confirmed to be significant with postoperative pneumonia ( 14 , 22 , 26 , 27 , 31 ), we also added the both to the algorithm.…”

Association between Concomitant Mediastinoscopy and Postoperative Pneumonia After Pulmonary Lobectomy

“…Meanwhile, more details of variables on patient demographics and characteristics should be included in this study. Clarification regarding the abovementioned omissions would greatly solidify the conclusions of the study by Yendamuri et al 1 DISCLOSURE Jiong-Jie Yu, Ju-Dong Li, and Tian Yang have no conflicts of interest to declare.…”

“…We read with great interest the article by Yendamuri et al 1 This retrospective study identified that mediastinoscopy may be associated with an increased risk of postoperative pneumonia after pulmonary lobectomy for patients with lung cancer. Herein, we would like to raise the following comments.…”

Reply to “Association Between Concomitant Mediastinoscopy and Postoperative Pneumonia After Pulmonary Lobectomy”

“…Yu, Li, and Yang for their comments on our recent publication. 1 Although already stated in the manuscript, we would like to reiterate that we do recognize that the comparison groups have differences between them, hence multivariable analyses have been performed and presented. The additional benefit of a propensity scorematched analysis is questionable.…”

“…Covariates included in the model depended on the dataset and are found in Tables 1 and 4 of the original article. 1 Based on the approach outlined by Stürmer et al, 3 the propensity scores were then trimmed and inverse probability weights (IPW) were calculated. A weighted logistic regression model, weighted by the IPW, was then used to estimate the effect of concomitant mediastinoscopy on the risk of postoperative pneumonia.…”