Effect of gender on perioperative outcomes after robotic-assisted pulmonary lobectomy

Abstract

Background: Female gender has been associated with worse outcomes after cardiovascular surgery and critical illness. We investigated the effect of gender on perioperative outcomes following robotic-assisted pulmonary lobectomy. 44.5%; P=0.004), the most common of which, in both women and men, were prolonged air leak for ≥7 days (13.0% vs. 22.7%, P=0.03), atrial fibrillation (7.1% vs. 14.8%, P=0.04), and pneumonia (7.8% vs. 10.2%, P=0.49). Hospital length of stay (LOS) (4±0.3 vs. 5±0.5 days) was also shorter for women (P=0.02). Despite the higher postoperative complication rate in men, in-hospital mortality did not differ between genders (P=0.23). Multivariable analyses did not identify female gender as an independent predictor of post-operative complications. Conclusions: Female gender was associated with rates of intraoperative complications and of conversion to open lobectomy as low as those for men, but with better perioperative outcomes, lower risk of intraoperative bleeding, and fewer postoperative complications. Thus, robotic-assisted pulmonary lobectomy is feasible and safe for women.

Trends and Outcomes of Salvage Lobectomy for Early-stage Non–Small Cell Lung Cancer

“…16 In addition, robotic-assisted pulmonary lobectomy was shown to produce similar rates of intraoperative complications in both sexes but fewer postoperative complications in women. 17 Consistent with previous literature, we found that squamous cell carcinoma histology and high-grade tumor were the factors associated with significantly worse OS. Squamous cell carcinoma histology is an independent prognosticator of worse survival in patients with early-stage NSCLC, 18 and patients with stage I squamous cell carcinoma have significantly worse outcomes than patients with stage I adenocarcinoma.…”

In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer Surgery: A Randomized Controlled Trial

“…Female gender has been linked to shorter length of stay and fewer postoperative complications. 39,40 We found no difference in pain between the groups 3 months after surgery. This is in contrast to the results presented by Reeve et al 15 This could be due to the fact that the patients in our study reported low levels of pain, with 50% of the patients reporting no pain at rest.…”

“…Female gender has been linked to shorter length of stay and fewer postoperative complications. 39,40…”

Perioperative Outcomes for Stage I Non-Small Cell Lung Cancer: Differences Between Men and Women

“…Explanations for these findings are still elusive; however, these findings suggest that sex may modify the impact of other factors on mortality. Other centers have similarly shown that perioperative complications are decreased among women after lung resection [16][17][18][19][20][21]. In terms of unplanned readmission after lung resection, results are mixed, with some studies showing no relationship by sex [37,38], and other large database studies showing an increased risk among men of unplanned readmission [21,39,40].…”

“…Prior studies have shown that the risk of perioperative complications between men and women after lung resection are different [15][16][17][18][19][20][21]. However, limitations of these prior studies include unmeasured confounding, lack of important granular detail from nationwide databases, and mixed results.…”