Evidence map›Paper›PMID 42423783›Full record

ArticleSurgery today2026

Incidence and outcomes of pulmonary artery injury during anatomical lung resection for lung cancer: a nationwide database study in Japan.

Hideo Ichimura, Hiroyuki Yamamoto, Yukio Sato, Masayuki Chida, Ichiro Yoshino, Yoshinori Okada, Masayoshi Inoue, Yasushi Hoshikawa, Hiroyuki Ito, Hidetaka Uramoto and 8 more

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Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

18 authors.

Hideo IchimuraDepartment of Thoracic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan. ichimura@md.tsukuba.ac.jp.ORCID http://orcid.org/0000-0002-2779-0108
Hiroyuki YamamotoDepartment of Healthcare Quality Assessment, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Yukio SatoDepartment of Thoracic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Masayuki ChidaDepartment of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan.
Ichiro YoshinoDepartment of Thoracic Surgery, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan.
Yoshinori OkadaDepartment of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Masayoshi InoueDivision of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
Yasushi HoshikawaDepartment of Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Hiroyuki ItoDepartment of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
Hidetaka UramotoDepartment of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
Yasushi ShintaniDepartment of General Thoracic Surgery, The University of Osaka, Suita, Japan.
Toshihiko SatoDepartment of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Fukuoka, Japan.
Toyofumi Fengshi Chen-YoshikawaDepartment of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Keisuke AsakuraDivision of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Mariko FukuiDepartment of General Thoracic Surgery, Juntendo University, Bunkyo- ku, Tokyo, Japan.
Masafumi KawamuraSchool of Medicine, Teikyo University, Itabashi-ku, Tokyo, Japan.
Yukinori SakaoDepartment of Surgery, Teikyo University School of Medicine, Itabashi- ku, Tokyo, Japan.
Shinichi ToyookaDepartment of General Thoracic Surgery and Brest and Endocrinological Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the incidence, characteristics, and perioperative outcomes of pulmonary artery (PA) injury during lung cancer surgery using data from the Japanese National Clinical Database (NCD).

methodsWe analyzed patients who underwent lobectomy or segmentectomy for clinical stage I-III primary lung cancer registered in the NCD between 2018 and 2021. The clinicopathological features and perioperative outcomes were compared between patients with and without PA injury. Subgroup analyses were performed according to blood loss categories and the causes of mortality.

resultsPA injury occurred in 1,325 of 142,343 patients (0.9%). It was more frequent in older patients, those with a higher BMI, advanced-stage disease, and left upper lobe resections. PA injury was associated with longer operative duration, greater blood loss, and higher transfusion rates. Postoperative complications were more frequent in the PA injury group. Thirty-day mortality (1.2% vs. 0.4%) and operative mortality (1.5% vs. 0.6%) rates were higher. Mortality was notably higher when intraoperative blood loss exceeded 2000 mL, regardless of PA injury. A female sex, obesity, and cN0 status were more common among patients with PA injury-related mortality.

conclusionsIntraoperative PA injury occurred in nearly 1% of resections and it was associated with poor outcomes. A hemorrhage exceeding 2000 mL may therefore be a critical mortality marker.

Indexed as

Anatomical lung resectionLung cancerMorbidityMortalityPulmonary artery injury

Identifiers

PMID42423783

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