Reporting of patient safety incidents in minimally invasive thoracic surgery: a national registered thoracic surgeons experience for improvement of patient safety

Abstract

Objectives The reporting of patient-safety incidents occurring in minimally invasive thoracic surgery is crucial. However, previous reports focused mainly on catastrophic events whereas minor events are often underreported. Methods All voluntary reports of minimally invasive thoracic surgery-related patient-safety incidents were retrospectively extracted from the French REX database for “in-depth analysis”. From 2008 to 2019, we retrospectively analyzed and graded events according to the WHO classification of patient-safety incidents: near miss events, no harm incidents and harmful incidents. Causes and corrective measures were analyzed according to the human-technology-organization triad. Results Of the 5145 cardiothoracic surgery patient-safety incidents declared, 407 were related to minimally invasive thoracic surgery. Among them, minimally invasive thoracic surgery was performed for primary lung cancer in 317 (78%) and consisted in a lobectomy in 249 (61%) patients. Patient-safety incidents were: near miss events in 42 (10%) patients, no harm incidents in 81 (20%) patients and harmful incidents in 284 (70%) patients (mild: n = 163, 40%; moderate: n = 78, 19%; severe: n = 36, 9%; and deaths: n = 7, 2%). Human factors represented the most important cause of PSIs with 267/407 (65.6%) cases, including mainly vascular injuries (n = 90; 22%) and non-vascular injuries (n = 43; 11%). Pulmonary arteries were the most affected site with 57/91 cases (62%). In all, there were 7 deaths (2%), 53 patients required second surgery (13%) and 30 required additional lung resection (7%). Conclusions The majority of reported minimally invasive thoracic surgery-related patient-safety incidents were non-catastrophic. Human factors were the main cause of patient-safety incidents. Systematic reporting and analysis of these patient-safety incidents will allow surgeon and his team to avoid a large proportion of them.

Beyond the Frontline: A Triple-Line Approach of Thoracic Surgeons in Lung Cancer Management—State of the Art

“…These reconstructions provide a detailed visualization of the patient’s anatomy and surgical margin [ 80 ]. By incorporating advanced imaging and reconstruction techniques, surgeons can better navigate the complex anatomy of the lungs, perform precise, targeted resections, and reduce adverse events [ 90 , 91 ].…”