Morbidity of antireflux surgery in lung transplant and matched nontransplant cohorts is comparable,Surgical Endoscopy

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Morbidity of antireflux surgery in lung transplant and matched nontransplant cohorts is comparable
Surgical Endoscopy ( IF 2.4 ) Pub Date : 2022-09-21 , DOI: 10.1007/s00464-022-09598-9
Deepika Razia _{1,

2} , Sumeet K Mittal _{1,

2} , Rajat Walia _{1,

2} , Sofya Tokman _{1,

2} , Jasmine L Huang _{1,

2} , Michael A Smith _{1,

2} , Ross M Bremner _{1,

2}

Affiliation

Background

Safety data on perioperative outcomes of laparoscopic antireflux surgery (LARS) after lung transplantation (LT) are lacking. We compared the 30-day readmission rate and short-term morbidity after LARS between LT recipients and matched nontransplant (NT) controls.

Methods

Adult patients who underwent LARS between January 1, 2015, and October 31, 2021, were included. The participants were divided into two groups: LT recipients and NT controls. First, we compared 30-day readmission rates after LARS between the LT and NT cohorts. Next, we compared 30-day morbidity after LARS between the LT cohort and a 1-to-2 propensity score-matched NT cohort.

Results

A total of 1328 patients (55 LT recipients and 1273 NT controls) were included. The post-LARS 30-day readmission rate was higher in LT recipients than in the overall NT controls (14.5% vs. 2.8%, p < 0.001). Compared to matched NT controls, LT recipients had a lower prevalence of paraesophageal hernia, a smaller median hernia size, and higher peristaltic vigor. Also compared to the matched NT controls, the LT recipients had a lower median operative time but a longer median length of hospital stay. The proportion of patients with a post-LARS event within 30 postoperative days was comparable between the LT and matched NT cohorts (21.8% vs 14.5%, p = 0.24).

Conclusions

Despite a higher perceived risk of comorbidity burden, LT recipients and matched NT controls had similar rates of post-LARS 30-day morbidity at our large-volume center with expertise in transplant and foregut surgery. LARS after LT is safe.

Graphical abstract

中文翻译：

肺移植和匹配的非移植队列中抗反流手术的发病率相当

背景

缺乏关于肺移植 (LT) 后腹腔镜抗反流手术 (LARS) 围手术期结果的安全性数据。我们比较了 LT 接受者和匹配的非移植 (NT) 对照者在 LARS 后的 30 天再入院率和短期发病率。

方法

纳入了在 2015 年 1 月 1 日至 2021 年 10 月 31 日期间接受 LARS 的成年患者。参与者分为两组：LT 接受者和 NT 对照组。首先，我们比较了 LT 和 NT 队列在 LARS 后的 30 天再入院率。接下来，我们比较了 LT 队列和 1 比 2 倾向评分匹配的 NT 队列之间 LARS 后 30 天的发病率。

结果

总共包括 1328 名患者（55 名 LT 接受者和 1273 名 NT 对照）。LT 接受者的 LARS 后 30 天再入院率高于整体 NT 对照组（14.5% 对 2.8%，p < 0.001）。与匹配的 NT 对照相比，LT 接受者的食管旁疝患病率较低，疝中值较小，蠕动活力较高。与匹配的 NT 对照组相比，LT 接受者的中位手术时间更短，但中位住院时间更长。LT 和匹配的 NT 队列在术后 30 天内发生 LARS 后事件的患者比例相当（21.8% 对 14.5%，p = 0.24）。