Incidence and risk factors of poor healing in closed drainage incisions among elderly patients undergoing thoracoscopic pulmonary resection for lung cancer
10.3760/cma.j.issn.0254-9026.2025.07.006
- VernacularTitle:老年肺癌患者胸腔镜肺切除术后闭式引流切口愈合不良发生情况及影响因素分析
- Author:
Yuguo CHEN
1
;
Yi TIAN
;
Congying JI
;
Yiou DENG
;
Mintao WANG
;
Junmei WANG
;
Peng JIAO
Author Information
1. 北京医院外科换药室 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Publication Type:Journal Article
- Keywords:
Pneumonectomy;
Wound healing;
Lung Neoplasms
- From:
Chinese Journal of Geriatrics
2025;44(7):877-882
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and risk factors associated with poor healing in closed drainage incisions among elderly lung cancer patients(aged ≥65 years)undergoing thoracoscopic pulmonary resection.Methods:A retrospective cohort study was conducted involving 471 elderly lung cancer patients who underwent single utility port video-assisted thoracic surgery(VATS)pulmonary resection at Beijing Hospital from January 1, 2022, to December 31, 2023.Patients were categorized into'healed’and'poor healing’groups based on the development of grade B/C healing following the removal of the closed drainage tube.A comparative analysis of demographic characteristics, medical history, and perioperative parameters between the groups was performed.Multivariate logistic regression analysis was employed to identify independent risk factors for poor incision healing.Results:A total of 471 elderly lung cancer patients who underwent VATS lobectomy were enrolled, with a mean age of 71.16 ± 3.44 years. Among them, 200(42.46%)were male and 271(57.54%)were female.Among 471 patients, 101(21.44%)developed poor healing, all classified as grade B. Univariate analysis revealed statistically significant differences between the two groups regarding BMI( χ2=1.632, P=0.004), diabetes mellitus( χ2=1.558, P=0.004), prolonged drainage duration ( χ2=1.829, P=0.002), and the extent of pulmonary resection( χ2=2.571, P=0.042).Multivariate logistic regression analysis indicated that a BMI of ≥24 kg/m 2( OR=1.534, 95% CI: 1.191-3.289, P=0.033), drainage tube indwelling time exceeding 4 days postoperatively( OR=1.712, 95% CI: 1.014-3.791, P=0.036), and diabetes mellitus( OR=1.855, 95% CI: 1.418-4.015, P=0.002)were significant factors influencing poor wound healing, with statistically significant differences noted( P<0.05). Conclusions:BMI, prolonged drainage duration, diabetes mellitus, and the extent of pulmonary resection are independent risk factors for poor healing of closed drainage incisions in elderly lung cancer patients following VATS.Clinical strategies should prioritize the control of BMI, perioperative glycemic management, real-time monitoring of drainage, and timely removal of tubes to mitigate complications.
