Risk factors for conversion to thoracotomy from video-assisted thoracoscopic surgery of lung cancer

Intraoperative conversion to thoracotomy from video-assisted thoracoscopic surgery (VATS) is associated with increased adverse events, which is a major concern. We aim to explore the related risk factors in lung cancer patients. In our study, the data from 1305 patients who underwent VATS between June 2017 and May 2020 were retrospectively collected, among which 67 patients underwent unexpected conversion to thoracotomy. All patients were divided into Non-conversion Group or Conversion Group according to whether they required a conversion to thoracotomy and the risk factors were explored by univariate and multivariate analyses. The most common cause of conversion was fibrocalcified lymph nodes, found in 33 patients (49.3%). Multivariable logistic regression analysis demonstrates that the independent risk factors for the conversion were age ≥65 y (OR = 2.696, 95% CI: 1.487–4.887, p = 0.001), tumor size >3 cm (OR = 4.527, 95% CI: 2.490–8.233, p