Perioperative risk factors for atrial fibrillation (AF) in patients underwent uniportal video-assisted thoracoscopic (VA

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ORIGINAL ARTICLE

Perioperative risk factors for atrial fibrillation (AF) in patients underwent uniportal video‑assisted thoracoscopic (VATS) pneumonectomy versus open thoracotomy: single center experience Samer Al Sawalhi1 · Junrong Ding1 · Jacopo Vannucci1,2 · Yuping Li1 · Ahmad Odeh3 · Deping Zhao1 Received: 25 July 2020 / Accepted: 10 September 2020 © The Japanese Association for Thoracic Surgery 2020

Abstract Objectives  To evaluate perioperative risk factors for AF in patients undergoing uniportal VATS pneumonectomy versus open thoracotomy, and to investigate mediastinal lymph nodes dissection (MLND) on the occurrence of AF. Methods  Patients were divided into 2 groups based on the surgical approach: uniportal VATS and open pneumonectomy. Analysis was done using chi-square test. Multiple variables were tested using univariate analysis. A p value ≤ 0.05 was considered statistically significant. Results  Three-hundred and forty-one patients underwent pneumonectomy between 2014 and 2018 in Shanghai Pulmonary Hospital. Fifty-eight patients underwent uniportal VATS, and 283 underwent thoracotomies. AF was the most common event observed. The overall occurrence of peri-operative AF was 33/341 (9.67%). In the uniportal, converted, and open group the incidence of AF was: 3/52 (5.76%), 1/6 (16.6%), and 29/283 (10.42%), respectively. Overall, there was no specific surgical technique correlated with increased incidence of AF (p = 0.432). By univariate analysis; large tumor size > 4.5 cm (p  125 min (p  120 mL predisposed to developing AF. The total number of mediastinal lymph nodes resected in operations performed by uniportal VATS was [5–30, mean 12.1], which matched the open group [3–28, mean 11.4] (p = 0.290, not shown). Number

of lymph nodes harvested was not related to the incidence of AF (p = 0.520). The median postoperative hospital length of stay was 6 days for the uniport VATS group compared to 9 days for the open group (p