Comprehensive assessment of risk factors and pathogenic characteristics of wound infections following thoracoscopic radical resection for lung cancer

Lung cancer remains a leading cause of cancer-related mortality, with surgical resection as a primary treatment modality. However, postoperative wound infections (PWIs) pose significant risks following thoracoscopic radical resection. This study aims to identify the risk factors and pathogenetic characteristics associated with PWIs in lung cancer surgery. A comprehensive retrospective study was conducted from August 2021 to June 2023 at our institution. The study included 30 patients who developed PWIs and 60 controls who did not, following thoracoscopic radical resection for lung cancer. We evaluated various factors including age, hospital stay, intraoperative blood loss, body mass index (BMI), operation time, prophylactic antibiotic use, diabetes mellitus and tumour staging. Diagnostic criteria for PWIs were based on clinical signs and microbiological confirmation. Statistical analysis was performed using SPSS software, utilizing chi-square tests, and univariate and multivariate logistic regression analyses. The predominant pathogens identified in PWIs were Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Univariate analysis revealed operation time (≥4 h) and diabetes mellitus as significant risk factors for PWIs, while prophylactic antibiotic use was associated with a lower incidence of PWIs. Multivariate analysis further confirmed these findings, highlighting prolonged operation time and diabetes as significant predictors of PWIs, and antibiotic use as a protective factor. Prolonged operation time and diabetes mellitus significantly increase the risk of PWIs following thoracoscopic radical resection for lung cancer, whereas prophylactic antibiotics play a protective role. These findings underscore the importance of tailored preventive strategies in clinical practice to minimize the occurrence of postoperative infections and improve surgical outcomes in lung cancer patients.

Comprehensive analysis of risk factors for surgical site infections following thoracoscopic radical resection in patients with lung cancer

Surgical site infections (SSIs) post-thoracoscopic radical resection in lung cancer patients pose significant clinical challenges. This study aims to comprehensively identify the independent risk factors that influence the occurrence of SSIs following thoracoscopic radical resection for lung cancer. The study employed a retrospective analysis of 130 patients who underwent thoracoscopic radical resection for lung cancer. Inclusion and exclusion criteria were clearly defined, and ethical approvals were obtained. Patients were monitored for SSIs via clinical and biochemical markers, with data comprehensively gathered from electronic health records. Statistical analysis was rigorously conducted using SPSS v27.0, with methodologies including t-tests, Chi-square tests and logistic regression. The study aimed to identify independent risk factors for SSIs and incorporated a multidimensional assessment approach to provide robust, clinically relevant findings. Univariate analysis revealed surgical duration ≥3 h, non-usage of antibiotics, presence of diabetes and elevated levels of C-reactive protein (CRP) and procalcitonin (PCT) as significant correlates for SSIs. Multivariate analysis substantiated these factors as independent risk variables: surgery duration (odds ratio [OR] = 9.698, p < 0.05), presence of diabetes (OR = 6.89, p < 0.05), elevated CRP (OR = 7.306, p < 0.05) and elevated PCT (OR = 6.838, p < 0.05). Conversely, antibiotic administration served as a protective factor (OR = 0.572, p < 0.05). Surgical duration of 3 h or more, diabetes and elevated levels of CRP and PCT significantly heighten the risk for SSIs after thoracoscopic radical resection in lung cancer patients. Perioperative antibiotic administration acts as a protective factor. Clinicians should implement tailored preventative strategies to mitigate these identified risks.

Effects of serratus anterior plane block and thoracic paravertebral nerve block on analgesia, immune function and serum tumor markers in patients after thoracoscopic radical resection of lung cancer

We aimed to assess the effects of serratus anterior plane block (SAPB) and thoracic paravertebral nerve block (TPVB) on analgesia, immune function and serum tumor markers in patients after thoracoscopic radical resection of lung cancer. A total of 132 patients enrolled from February 2019 to November 2020 were prospectively selected and randomly divided into 3 groups (n=44). Control group received general anesthesia. After induction of general anesthesia, TPVB or SAPB group was given TPVB or SAPB. Their clinical data, operation conditions, Visual Analogue Scale (VAS) score, immune function, serum tumor markers and adverse reactions were compared. TPVB and SAPB groups had lower dosage of sufentanil during operation, later time of first pressing patient-controlled intravenous analgesia (PCA) pump after operation and smaller number of pressing PCA pump within 48 h after operation than those of control group (P<0.05). VAS scores at rest and coughing decreased 6 and 12 h after operation in TPVB and SAPB groups compared with that in control group (P<0.05). Cluster of differentiation 3 (CD3)⁺, CD4⁺ and CD4⁺/CD8⁺ ratio were higher, while CD8⁺ was lower 24 and 48 h after operation in TPVB and SAPB groups than those of control group (P<0.05). TPVB and SAPB groups had lower serum tumor marker levels 24 h after operation than those of control group (P<0.05). The three groups had similar incidence rates of adverse reactions (P>0.05). SAPB and TPVB can markedly improve postoperative analgesic effect, enhance immune function and decrease serum tumor marker levels in patients receiving thoracoscopic radical resection of lung cancer, without increasing adverse reactions. However, TPVB may puncture the pleura.