Abstract: Background　Follow-up facilitates early detection of delayed complications and disease recurrence after lobectomy，but quite a few patients may lose contact through telephone interview during follow-up.Objective　To explore reasons and influencing factors of lost to telephone follow-up after thoracoscopic lobectomy.Methods　By retrospective study design，we reviewed medical records of 267 patients with non-small cell lung cancer who received thoracoscopic lobectomy in Lung Cancer Center and Department of Thoracic Surgery in West China Hospital of Sichuan University from November 2013 to March 2015，collected relevant sociodemographic and clinical materials which may affect the postoperative follow-up，and tried to identify influencing factors of lost to follow-up by multivariate Logistic analysis.Results　Thirty-five patients （13.1%） were lost to follow-up.Among them，11（31.4%） had wrong or non-existence numbers，5（14.3%） had no answer，3（8.6%） had cell phone shutdown，3（8.6%） had phone overdue，1（2.8%） had phone with no signal，and 12（34.3%） were reluctant to respond.The results of univariate analysis of telephone follow-up after thoracoscopic lobectomy revealed that types of phone （χ2=7.950，P=0.019） and TNM staging （Z=7.823，P=0.005） showed statistical difference between patients who completed follow-up and who did not.The results of multivariate Logistic regression analysis further confirmed that types of phone  and TNM staging were independent prediction factors of follow-up responses （P<0.05）．Conclusion　For patients with lung cancer who are to receive thoracoscopic lobectomy，phone number changes，dissatisfaction of medical services and therapeutic effects，and distrust of the follow-up phone number are possible reasons of lost to follow-up.Patients who only leave landline phone numbers on their medical record and patients with advanced TNM stages are more likely to lost in the telephone follow-up.It is justified for health organizations to take more measures to improve response rate in those postoperative patients with high risks.

Key words: Lung neoplasms, Thoracoscopy, Pneumonectomy, Lost to follow-up, Root cause analysis

摘要： 背景　随访有利于及时发现肺癌术后出院患者的迟发并发症及复发，然而较多患者会在随访中失访。目的　探讨胸腔镜肺叶切除术后肺癌患者电话随访失访的原因，并分析其影响因素。方法　采用回顾性研究设计，选取2013年11月—2015年3月于四川大学华西医院肺癌中心及胸外科接受胸腔镜肺叶切除术的非小细胞肺癌患者267例，收集相关可能影响术后随访的社会人口学及临床资料，然后根据电话随访结果行多因素Logistic回归分析。结果　共失访患者35例（13.1%），其中电话号码错误或不存在11例（31.4%），电话无人接听5例（14.3%），手机关机3例（8.6%），电话停机3例（8.6%），电话无信号1例（2.8%），不愿应答12例（34.3%）。单因素分析显示，完成随访与失访患者电话类型及TNM分期比较，差异有统计学意义（χ2=7.950，P=0.019；Z=7.823，P=0.005）。多因素Logistic回归分析结果显示，电话类型及TNM分期与胸腔镜肺叶切除术后肺癌患者电话随访失访有回归关系（P<0.05）。结论　对拟行胸腔镜肺叶切除术的肺癌患者，电话号码更改、医疗服务和效果未达患者预期、对随访电话的不信任等为可能的失访原因，仅预留固定电话和TNM分期晚期是增加失访率的危险因素。对术后失访高危患者，医疗机构应采取更多应对措施，从而提高随访应答率。

关键词: 肺肿瘤, 胸腔镜检查, 肺切除术, 失访, 影响因素分析