虽然小气道功能障碍是常见的呼吸功能异常，但其在肺癌手术后的预后常常被忽视。本研究调查了接受肺癌胸腔镜手术的患者中小气道功能障碍与结局的关系。在宁波第一医院，我们进行了一项回顾性队列研究，包括2019年12月至2021年3月接受胸腔镜手术的患者。我们使用单因素和多因素分析来评估术后结局与临床变量之间的可能关联，包括小气道功能障碍。为了平衡潜在混杂因素，我们进行倾向性评分匹配，建立了一比一的小气道功能障碍组和小气道正常功能组的匹配。在这项研究中，共有1,012名接受肺癌胸腔镜手术的患者入组。小气道功能障碍在患者中的发生率为18.7%（189/1,012）。小气道功能障碍组术后的肺部并发症发生率高于小气道正常功能组（16.4% vs 6.2%，P < .001）。小气道功能障碍组和小气道正常功能组中最显著的术后肺部并发症分别是肺炎（7.4% vs 2.4%，P < .001）。此外，小气道功能障碍组的中位住院天数明显延长，与小气道正常功能组相比（中位数[四分位数范围]，9 [7-12] vs 8 [7-9]，P < .001）。经过一比一倾向性评分匹配，比较了298名患者（149对）中的小气道功能障碍和小气道正常功能，这种关联仍然存在。小气道功能障碍组仍然存在较高的术后肺部并发症发生率（13.4% vs 6.0%，P = .032），住院天数仍然更长（中位数[四分位数范围]，9 [7-11] vs 8 [6-10]天，P = .001）。多因素分析表明，小气道功能障碍是与术后肺部并发症（比值比 = 2.694，95%可信区间：1.640-4.426，P < .001）和住院时间延长（贝塔 = 1.045，标准差 = 0.159，95%可信区间：0.733-1.357，P < .001）相关的独立风险因素。我们的研究表明，小气道功能障碍增加了接受肺癌胸腔镜手术患者术后肺部并发症的发生率，并延长了住院时间。版权所有© 2023 Elsevier Inc.。保留所有权利。

Although small airway dysfunction is a common respiratory dysfunction, its prognosis after lung cancer surgery is often neglected. This study investigated the relationship between small airway dysfunction and outcomes in patients who underwent thoracoscopic surgery for lung cancer.A retrospective cohort study of patients who underwent thoracoscopic surgery was conducted between December 2019 and March 2021 at Ningbo First Hospital. We used univariate and multivariate analyses to assess the possible associations between postoperative outcomes and clinical variables, including small airway dysfunction. To balance the potential confounding factors, propensity score matching was performed to establish 1:1 small airway dysfunction and small airway normal function group matching.In this study, 1,012 patients undergoing thoracoscopic surgery for lung cancer were enrolled. Small airway dysfunction was present in 18.7% of patients (189/1,012). The incidence of postoperative pulmonary complications in the small airway dysfunction group was higher than that of the small airway normal function group (16.4% vs 6.2%, P < .001). The most significant postoperative pulmonary complications were pneumonia (7.4% vs 2.4%, P < .001) in the small airway dysfunction and normal function groups, respectively. In addition, a significantly prolonged median hospital length of stay was observed in the small airway dysfunction group compared to the small airway normal function group (median [interquartile range], 9 [7-12] vs 8 [7-9], P < .001). After 1:1 propensity score matching, 298 patients (149 pairs) were included in the comparison between small airway dysfunction and small airway normal function, and this association remained. Postoperative pulmonary complications (13.4% vs 6.0%, P = .032) were still higher, and length of stay (median [interquartile range] 9 [7-11] vs 8 [6-10] days, P = .001) was still longer in the small airway dysfunction group. Multivariate analysis indicated that small airway dysfunction was the independent risk factor associated with both postoperative pulmonary complications (odds ratio = 2.694, 95% confidence interval: 1.640-4.426, P < .001) and prolonged length of stay (beta = 1.045, standard error = 0.159, 95% confidence interval: 0.733-1.357, P < .001).Our study showed that small airway dysfunction increased the incidence of postoperative pulmonary complications and prolonged length of stay in patients undergoing thoracoscopic surgery for lung cancer.Copyright © 2023 Elsevier Inc. All rights reserved.