Analysis of perioperative risk factors and development of predictive models for complications following CT guided microwave ablation of pulmonary nodules.

Lung cancer has the highest incidence and mortality rates globally. Currently, curative surgical resection remains the primary treatment for early-stage lung cancer. However, 60% of lung cancer patients are ineligible for surgery due to various reasons (such as poor cardiopulmonary function or refusal of surgery). Microwave ablation of pulmonary nodules is an effective local treatment method that preserves lung parenchyma. However, being an invasive procedure, postoperative complications are inevitable in some patients. There is currently a scarcity of research that examines perioperative factors comprehensively, with few predictive models available in this context. Through analyzing the clinical data of 117 patients undergoing microwave ablation, our study identified BMI (Body mass index), emphysema, reduced lung diffusion capacity, and number of pleural punctures as independent risk factors for pneumothorax in patients with pulmonary nodules undergoing microwave ablation. Additionally, postoperative electrolyte imbalance was recognized as an early independent predictor for pneumothorax in these patients. Emphysema, tumor-pleura distance ≤ 10 mm, and maximum ablation power represent independent risk factors for postoperative pleural effusion after lung microwave ablation, while postoperative neutrophils count serves as an early independent predictive factor. The nomogram prediction models based on the above variables demonstrate strong predictive value, offering valuable guidance for clinical decision-making.