Predictive factors of cough after uniportal video-assisted thoracoscopic pulmonary resection

Liu-Ying Pan, Li-Ping Peng, Chun Xu, Cheng Ding, Jun Chen, Wen-Yi Wang, Xin-Yu Zhu, Jun Zhao, Chang Li, Liu-Ying Pan, Li-Ping Peng, Chun Xu, Cheng Ding, Jun Chen, Wen-Yi Wang, Xin-Yu Zhu, Jun Zhao, Chang Li

Abstract

Background: Cough is one of the shared complications after lung surgery. In this study, a prospective analysis was conducted for exploring the risk factors of persistent cough after uniportal video-assisted thoracoscopic pulmonary resection.

Methods: One hundred thirty-five patients with pulmonary nodules who underwent surgical treatment in the same surgical group from November 2019 to January 2020 were enrolled in this prospective study. The severity of cough and its impact on patients' quality of life before and after surgery were assessed by the Mandarin Chinese version of the Leicester cough questionnaire (LCQ-MC), and postoperative cough was tested by the cough visual analog scale (VAS) and cough symptom score (CSS). Risk factors of cough after pulmonary resection (CAP) were determined by univariate and multivariate logistic regression analysis.

Results: The incidence of postoperative cough was 24.4% (33 of 135 patients). Univariate analysis showed that gender (female), the surgical site (upper right), the resection (lobectomy), subcarinal lymph node dissection, postoperative acid reflux, length of hospitalization contributed to the development of CAP resection. Multivariate logistic regression analysis showed that the resection (lobectomy) (OR 3.590, 95% CI: 0.637-20.300, P=0.017), subcarinal lymph node dissection (OR 4.420, 95% CI: 1.342-14.554, P=0.001), postoperative acid reflux (OR 13.55, 95% CI: 3.186-57.633, P<0.001) and duration of anesthesia (over 153 minutes, OR 0.987, 95% CI: 0.978-0.997, P=0.011) were independent risk factors for postoperative cough.

Conclusions: The application of uniportal video-assisted thoracoscopic techniques to several types of lung surgery are conducive to enhanced recovery after surgery (ERAS). Postoperative cough is related to an ocean of factors, the resection (lobectomy), subcarinal lymph node dissection, postoperative acid reflux, and duration of anesthesia (over 153 minutes) are independent high-risk factors for CAP resection.

Trial registration: This study was registered on ClinicalTrials.gov (NCT04204148).

Keywords: Cough after pulmonary resection (CAP); enhanced recovery after surgery (ERAS); risk factor; uniportal video-assisted thoracoscopic surgery (uniportal VATS).

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-2652). The authors have no conflicts of interest to declare.

2020 Journal of Thoracic Disease. All rights reserved.

Figures

Figure 1
Figure 1
Patient flowchart. VATS, video-assisted thoracoscopic surgery; VAS, visual analog scale; CSS, cough symptoms score.

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