Effect of high body mass index on perioperative complications under thoracoscope radical resection of lung cancer and its clinical efficacy

Abstract

Objective To investigate the effect of high body mass index (BMI) on perioperative complications under thoracoscope radical resection of lung cancer and its clinical efficacy. Methods A total of 235 patients who received pulmonary radical resection under thoracoscope between January 2012 and December 2017 in Department of Thoracic Surgery of the First Hospital of Lanzhou University were retrospectively analyzed. The patients were divided into normal BMI group (BMI≥18.5 kg/m2 and BMI < 24.0 kg/m2, n = 147) and high BMI group (BMI≥24.0 kg/m2, n = 88) according to BMI in China. The incidence of postoperative complications and clinical efficacy were compared by using χ 2 test and t test. Logistic regression was used to identify that if high BMI was the independent risk factor of postoperative pulmonary infection in patients with lung cancer. Results The incidence of the complications in high BMI group was higher than that in normal BMI group, including pulmonary infection [17.0% (15/88) vs. 6.1% (9/147), χ2 = 7.162, P < 0.05], pulmonary atelectasis [11.4% (10/88) vs. 3.4% (5/147), χ2 = 5.840, P < 0.05], respiratory failure [5.7% (5/88) vs. 0.1% (1/147), χ2 = 5.535, P < 0.05] and poor wound healing [10.2% (9/88) vs. 3.4% (5/147), χ2 = 4.578, P < 0.05]. Postoperative recovery time [(7.1±1.4) d vs. (6.7±0.8) d, t = 2.706, P < 0.05], chest drainage tube removal time [(3.8±1.6) d vs. (3.4±0.7) d, t = 3.089, P < 0.05] in high BMI group were longer than those in normal BMI group. Multiple-factor analysis showed that the independent risk factors were diabetes, high blood pressure, high BMI, long operation time, old age, smoking history (all P < 0.05). Conclusions The incidence of pulmonary infection, pulmonary atelectasis and poor wound healing for the patients with high BMI is increased. Besides, postoperative recovery time and chest drainage tube removal time are prolonged. High BMI is an independent risk factor of pulmonary infection. Key words: Body mass index; Lung neoplasms; Lobectomy; Perioperative complications