Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: A propensity-matched analysis from the STS database

Paul, Subroto; Altorki, Nasser K.; Sheng, Shubin; Lee, Paul C.; Harpole, David H.; Onaitis, Mark W.; Stiles, Brendon M.; Port, Jeffrey L.; D’Amico, Thomas A.

doi:10.1016/j.jtcvs.2009.08.026

Cited by 671 publications

(432 citation statements)

References 26 publications

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“…It is clear that with growing experience, the success rate of performing complex lung surgery using uniportal VATS improves. Unfortunately, publications on conversion to thoracotomy, placement of an additional port or complications as a function of experience during the adoption of the uniportal approach for lung resection are scarce (5,16), which restrains comparisons that can be made with our series.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, thoracoscopic surgery is the preferred approach for lung anatomic resection in current practice guidelines for the treatment of early-stage lung cancer (1,2) as well as for most benign intrathoracic pathologies. Benefits include decreased blood loss, decreased pain, shorter length of hospital stay and fewer complications (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Drevet¹,

Figueroa²

2016

Ann. Cardiothorac. Surg.

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Background: Video-assisted thoracoscopic surgery (VATS) using a single incision (uniportal) may result in better pain control, earlier mobilization and shorter hospital stays. Here, we review the safety and efficiency of our initial experience with uniportal VATS and evaluate our learning curve. Methods:We conducted a retrospective review of uniportal VATS using a prospectively maintained departmental database and analyzed patients who had undergone a lung anatomic resection separately from patients who underwent other resections. To assess the learning curve, we compared the first 10 months of the study period with the second 10 months. Conclusions: Uniportal VATS was safe and feasible for both standard and complex pulmonary resections.However, when used for pulmonary anatomic resections, uniportal VATS entails a steep learning curve.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Drevet¹,

Figueroa²

2016

Ann. Cardiothorac. Surg.

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“…This surgical technique has decreased the length of post-operative stay and complications for patients undergoing lung resection compared with open thoracotomy (1). Although it has many advantages, one important disadvantage is that it removes the surgeon's tactile perception, often making it difficult to resect small pulmonary nodules that are difficult to palpate such as those that are deep in the lung parenchyma or have ground glass morphology.…”

Section: Introductionmentioning

confidence: 99%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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Background: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface.Methods: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014.Results: A total of 63 patients were included (37% male, mean age 61.6±11.4 years). Forty-two patients (67%) had a history of smoking, with 10 current smokers. Sixty one (97%) patients underwent wedge resection and 3 (5%) patients had segmentectomy. Three (5%) patients required intra-operative staple line re-resection for positive or close margins. Eleven (17%) patients had a completion lobectomy, 5 of which were during the same anaesthetic. The average time between the CT-guided insertion and start of operation was 136.6±89.0 min, and average operative time was 84.0±53.3 min. The intra-operative complication rate was 5% (n=3), including 1 episode of hemoptysis, and 2 conversions to thoracotomy. The post-operative complication rate was 8% (5 patients), and included 2 air leaks, 1 hemothorax (drop in hemoglobin), 1 post chest tube removal pneumothorax, and one venous infarction of the lingula after lingula-sparing lobectomy requiring completion lobectomy. . Average post-operative length of stay was 2.2 days. A diagnosis was made for all patients.Conclusions: CT-guided microcoil insertion followed by VATS lobectomy is safe, with short operative times, short length of stay and 100% diagnosis of small pulmonary nodules. This technique will become more important in the future with increasing numbers of small nodules detected on CT as part of lung cancer screening programs.

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“…Minimally invasive procedures offer today unprecedented outcomes in morbidity and patient comfort (1).…”

Section: Introductionmentioning

confidence: 99%

Subxiphoid complex uniportal video-assisted major pulmonary resections

et al. 2017

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In recent years, the search for a less invasive and thus, less painful approach has driven technical innovation in modern thoracic surgery. In this context, subxiphoid uniportal approach has emerged as an alternative to avoid intercostal space manipulation and decrease postoperative pain and intercostal nerve chronic impairment. Subxiphoid uniportal major lung resections have been safe and effective procedures when performed by experienced surgeons even in complex cases or unexpected intraoperative situations. We present six of these surgical scenarios such as big tumors, incomplete or absent fissures, hilar calcified lymph nodes, active bleeding and massive adhesions to show the feasibility of subxiphoid approach to manage even these conditions.

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Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: A propensity-matched analysis from the STS database

Abstract: Video-assisted thoracoscopic lobectomy is associated with a lower incidence of complications compared with lobectomy via thoracotomy. For appropriate candidates, video-assisted thoracoscopic lobectomy may be the preferred strategy for appropriately selected patients with lung cancer.

Cited by 671 publications

References 26 publications

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

Subxiphoid complex uniportal video-assisted major pulmonary resections

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