Abstract
OBJECTIVES: This study aimed to provide Chinese data on Days Alive and Out of Hospital (DAOH) following video-assisted thoracoscopic surgery (VATS) lobectomy or segmentectomy. METHODS: The analyzed data was derived from a prospective cohort study. Consecutive patients who underwent either VATS lobectomy or segmentectomy from April 2021 to July 2022 were included. The primary outcome was DAOH within the first 90 days postoperatively (DAOH90). The secondary outcomes were identifying the predominant complications and reasons for readmission during the DAOH90. Additionally, we utilized multivariate logistic regression to identify factors independently associated with decreased DAOH90. RESULTS: A total of 919 primary lung cancer patients were included. The median DAOH90 was 86 days (IQR, 85–87). The predominant postoperative complications within postoperative 90 days (POD90) were pneumonia (22.5%), pleural pneumothorax (15.8%), incision dehiscence (13.8%) and pleural effusion (12.8%). The primary causes of readmission in POD90 included pleural effusion (10 cases), pneumonia (7 cases), and incision dehiscence (4 cases). Age (P < .001), operative time (P < .001), operative bleeding (P = .023) and multiportal VATS (compared with robot-assisted VATS) were independently associated with decreased DAOH90. CONCLUSIONS: In this study, the median DAOH90 following VATS lobectomy or segmentectomy was 86 days. Advanced age, longer surgical duration, more operative bleeding and multiportal VATS may be independent risk factors for “low DAOH90.” SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-026-04230-9.