Early predictor of bronchial suture failure after pneumonectomy

Vladimir Alekseyevich Porkhanov, Vasiliy A. Zhikharev, Alexander S. Bushuev, V. S. Zima, V. A. Koryachkin, М П Иванова

2023

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DOI 10.17116/hirurgia202310171
Data confidence 70 medium
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Abstract

Objective. To identify the relationship between serum CRP/albumin and bronchial suture failure after pneumonectomy. Material and methods. A retrospective analysis included 100 patients who underwent pneumonectomy with extended lymph node dissection for lung cancer. Patients were divided into 2 groups depending on postoperative complications: group 1 — bronchial stump failure, group 2 — no similar complications. In all patients, we analyzed markers of inflammation (C-reactive protein and albumin) in preoperative period and after 24 postoperative hours. Bronchial stump failure was found in 20 patients (10 patients (14.7%) after left-sided pneumonectomy and 10 (31%) patients after right-sided pneumonectomy). We found a significant relationship between serum CRP/albumin and bronchial stump failure after pneumonectomy (p<0.05). A prognostic formula was based on the ratio of serum C-reactive protein and albumin: PC = CRP/Alb, where PC — prognostic coefficient, CRP — serum C-reactive protein (mg/l) 24 hours after surgery, Alb — serum albumin (g/l) 24 hours after surgery. PC >2.6 determines high risk of bronchial stump failure after pneumonectomy, PC <2.6 — low risk. Sensitivity of this method is 90%, specificity — 97.5%.