ArticleFrontiers in surgery2026
Postoperative outcomes following anatomical lung resections in relation to intraoperative ventilation practices: a registry-based multicenter study.
Article in Frontiers in surgery, 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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Abstract
Background: Patients undergoing anatomical resection during thoracic surgery are exposed to an elevated risk of postoperative complications, particularly when one lung ventilation (OLV) is applied. The objective of this study is to evaluate the association between intraoperative ventilation parameters during OLV in anatomical resections and outcomes in this cohort. Methods: A retrospective multicenter cohort study was conducted using data from the German Thoracic Registry. Between 2015 and 2021 1128 patients underwent anatomical resection. Intraoperative parameters analyzed included driving pressure (DP), peak airway pressure (Pmax), positive end-expiratory pressure (PEEP), and tidal volume per predicted body weight (TV/PBW). The primary outcomes of the study were postoperative complications, respiratory complications, and in-hospital mortality. Results: The analysis included 1128 patients undergoing anatomical lung resections, with a postoperative complication rate of 28.7% and respiratory complications in 16.3%. Elevated DP >20 mbar ( Conclusion: In this registry-based cohort, univariable threshold analyses indicated higher postoperative and respiratory complication rates when intraoperative airway pressures and tidal volumes exceeded commonly used protective ranges. However, these findings should be interpreted as observational and hypothesis-generating, as adjusted models and sensitivity analyses suggest potential confounding by patient risk and procedural complexity. Prospective studies with standardized complication severity grading and detailed preoperative pulmonary characterization are needed.
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