Investigation of Influencing Factors for Vascular Injury and Bleeding during VATS Lobectomy
Objective:To explore the influencing factors for vascular injury and bleeding during video-assisted thoracic surgery(VATS)lobectomy,thereby providing evidence to inform surgical prevention strategies and tactics.Method:A retrospective analysis was conducted on 100 patients who underwent VATS at Yichun People's Hospital between January 2022 and October 2023,patients were divided into a bleeding group(n=9)and a non-bleeding group(n=91)based on intraoperative bleeding occurrences.Univariate analyses were performed on the clinical data of both groups of patients,statistically significant factors were subjected to multivariate regression analysis;receiver operating characteristic(ROC)curves was generated using statistical software.Result:Univariate analysis showed that the bleeding group had statistically significant differences compared to the non-bleeding group in terms of hemoglobin(Hb),platelet count(PLT),total cholesterol(CHOL),inadvertent injury to pulmonary artery branches,thin pulmonary artery and vein walls,pathological adhesions or inflammation,vascular anatomical variations and improper use of surgical instruments(P<0.05).Multivariate regression analysis revealed that Hb,PLT,CHOL,thin pulmonary artery and vein walls,pathological adhesions or inflammation,vascular anatomical variations and improper use of surgical instruments were influencing factors for vascular injury and bleeding during VATS(P<0.05).Conclusion:In VATS,inadvertent injury to pulmonary artery branches,thin vascular walls,pathological adhesions,inflammation,vascular anatomical variations and improper use of surgical instruments are associated with vascular injury and bleeding.Recognizing and preventing these risk factors can significantly reduce the incidence of intraoperative bleeding and enhance surgical safety.
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