| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2010;139:366-378
© 2010 The American Association for Thoracic Surgery
General Thoracic Surgery |
a Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York
b Duke Clinical Research Institute, Duke University Medical Center, Durham, NC
c Division of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
Received for publication May 14, 2009; revisions received August 11, 2009; accepted for publication August 16, 2009. * Address for reprints: Subroto Paul, MD, Division of Thoracic Surgery, Department of Cardiothoracic Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY 10065. (Email: pas2022{at}med.cornell.edu).
Background: Several single-institution series have demonstrated that compared with open thoracotomy, video-assisted thoracoscopic lobectomy may be associated with fewer postoperative complications. In the absence of randomized trials, we queried the Society of Thoracic Surgeons database to compare postoperative mortality and morbidity following open and video-assisted thoracoscopic lobectomy. A propensity-matched analysis using a large national database may enable a more comprehensive comparison of postoperative outcomes.
Methods: All patients having lobectomy as the primary procedure via thoracoscopy or thoracotomy were identified in the Society of Thoracic Surgeons database from 2002 to 2007. After exclusions, 6323 patients were identified: 5042 having thoracotomy, 1281 having thoracoscopy. A propensity analysis was performed, incorporating preoperative variables, and the incidence of postoperative complications was compared.
Results: Matching based on propensity scores produced 1281 patients in each group for analysis of postoperative outcomes. After video-assisted thoracoscopic lobectomy, 945 patients (73.8%) had no complications, compared with 847 patients (65.3%) who had lobectomy via thoracotomy (P < .0001). Compared with open lobectomy, video-assisted thoracoscopic lobectomy was associated with a lower incidence of arrhythmias [n = 93 (7.3%) vs 147 (11.5%); P = .0004], reintubation [n = 18 (1.4%) vs 40 (3.1%); P = .0046], and blood transfusion [n = 31 (2.4%) vs n = 60 (4.7%); P = .0028], as well as a shorter length of stay (4.0 vs 6.0 days; P < .0001) and chest tube duration (3.0 vs 4.0 days; P < .0001). There was no difference in operative mortality between the 2 groups.
Conclusions: 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.
This article has been cited by other articles:
|
|
 |
|
  B. C. Tong, M. R. Gustafson, S. S. Balderson, T. A. D'Amico, and S. L. Meyerson Validation of a thoracoscopic lobectomy simulator Eur J Cardiothorac Surg, February 6, 2012; (2012) ezs012v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. S. Park, F. C. Detterbeck, D. J. Boffa, and A. W. Kim Impact of Hospital Volume of Thoracoscopic Lobectomy on Primary Lung Cancer Outcomes Ann. Thorac. Surg., February 1, 2012; 93(2): 372 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Ramos, P. Girard, C. Masuet, P. Validire, and D. Gossot Mediastinal lymph node dissection in early-stage non-small cell lung cancer: totally thoracoscopic vs thoracotomy Eur J Cardiothorac Surg, January 6, 2012; (2012) ezr220v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Berry, M. W. Onaitis, B. C. Tong, S. S. Balderson, D. H. Harpole, and T. A. D'Amico Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection Eur J Cardiothorac Surg, December 20, 2011; (2011) ezr150v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Port, F. M. Mirza, P. C. Lee, S. Paul, B. M. Stiles, and N. K. Altorki Lobectomy in Octogenarians With Non-Small Cell Lung Cancer: Ramifications of Increasing Life Expectancy and the Benefits of Minimally Invasive Surgery Ann. Thorac. Surg., December 1, 2011; 92(6): 1951 - 1957. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Flores, U. Ihekweazu, J. Dycoco, N. P. Rizk, V. W. Rusch, M. S. Bains, R. J. Downey, D. Finley, P. Adusumilli, I. Sarkaria, et al. Video-assisted thoracoscopic surgery (VATS) lobectomy: Catastrophic intraoperative complications J. Thorac. Cardiovasc. Surg., December 1, 2011; 142(6): 1412 - 1417. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. DeCamp and M. P. Mehta Pro: Lung Cancer in 2011: A Time for Optimism and Investment in New Approaches and Technologies with a Commitment to Produce Evidence-Based Data Am. J. Respir. Crit. Care Med., December 1, 2011; 184(11): 1231 - 1234. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Yilmaz, B. P. Van Putte, and W.-J. Van Boven Closed chest lobectomy with subxyphoid retraction Interact CardioVasc Thorac Surg, December 1, 2011; 13(6): 549 - 551. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Dexter, E. U. Dexter, and J. Ledolter Statistical Grand Rounds: Importance of Appropriately Modeling Procedure and Duration in Logistic Regression Studies of Perioperative Morbidity and Mortality Anesth. Analg., November 1, 2011; 113(5): 1197 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Otake, H. Yasunaga, H. Horiguchi, N. Matsutani, S. Matsuda, and K. Ohe Impact of Hospital Volume on Chest Tube Duration, Length of Stay, and Mortality After Lobectomy Ann. Thorac. Surg., September 1, 2011; 92(3): 1069 - 1074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Yu, M. Pomerantz, A. Bishop, M. J. Weyant, and J. D. Mitchell Lady Windermere revisited: treatment with thoracoscopic lobectomy/segmentectomy for right middle lobe and lingular bronchiectasis associated with non-tuberculous mycobacterial disease Eur J Cardiothorac Surg, September 1, 2011; 40(3): 671 - 675. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. D'Amico, J. Niland, R. Mamet, C. Zornosa, E. U. Dexter, and M. W. Onaitis Efficacy of Mediastinal Lymph Node Dissection During Lobectomy for Lung Cancer by Thoracoscopy and Thoracotomy Ann. Thorac. Surg., July 1, 2011; 92(1): 226 - 232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Lee, B. C. Cho, M. K. Bae, C. Y. Lee, I. K. Park, D. J. Kim, and K. Y. Chung Thoracoscopic Lobectomy Is Associated With Superior Compliance With Adjuvant Chemotherapy in Lung Cancer Ann. Thorac. Surg., February 1, 2011; 91(2): 344 - 348. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kachare, E. U. Dexter, C. Nwogu, T. L. Demmy, and S. Yendamuri Perioperative outcomes of thoracoscopic anatomic resections in patients with limited pulmonary reserve J. Thorac. Cardiovasc. Surg., February 1, 2011; 141(2): 459 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. K. Kim, Y. S. Choi, J. Kim, Y. M. Shim, and K. Kim Outcomes of unexpected pathologic N1 and N2 disease after video-assisted thoracic surgery lobectomy for clinical stage I non-small cell lung cancer J. Thorac. Cardiovasc. Surg., December 1, 2010; 140(6): 1288 - 1293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. D'Amico Operative Techniques in Early-Stage Lung Cancer J Natl Compr Canc Netw, July 1, 2010; 8(7): 807 - 813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G. Hartwig and T. A. D'Amico Thoracoscopic Lobectomy: The Gold Standard for Early-Stage Lung Cancer? Ann. Thorac. Surg., June 1, 2010; 89(6): S2098 - S2101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Berry, N. R. Villamizar-Ortiz, B. C. Tong, W. R. Burfeind Jr, D. H. Harpole, T. A. D'Amico, and M. W. Onaitis Pulmonary Function Tests Do Not Predict Pulmonary Complications After Thoracoscopic Lobectomy Ann. Thorac. Surg., April 1, 2010; 89(4): 1044 - 1052. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
