Is it safe to perform completion lobectomy after diagnostic wedge resection using video-assisted thoracoscopic surgery?
- 25 February 2016
- journal article
- research article
- Published by Springer Science and Business Media LLC in General Thoracic and Cardiovascular Surgery
- Vol. 64 (4), 203-208
- https://doi.org/10.1007/s11748-016-0633-4
Abstract
Objectives The objective of this study was to assess the safety of video-assisted thoracoscopic surgery (VATS) completion lobectomy (CL) for non-small cell lung cancer (NSCLC) after diagnostic wedge resection by comparing with standard VATS lobectomy (SL). Methods Data were retrieved from an institutional database of consecutive VATS lobectomies between January 1st 2007 and December 31st 2013. Patients were grouped into CL or SL. Patient characteristics, operative data, converted procedures, complications, and mortality was compared using Pearson Chi square, Fisher’s exact test, or Mann–Whitney U test. Results In total 80 CL and 958 SLs were performed. There were no significant differences in median operating time, median chest drain duration or median length of stay. Median operative bleeding was 100 mL (IQR 50–238) in the CL group compared to 75 mL (IQR 25–200) in the SL group (p = 0.01). There were no differences between groups in major or minor complications. Median time from VATS wedge resection to CL was 33 days (IQR 27–41). Conversion rate was 1.3 % in the CL group and 2.6 % in the SL group (p = 0.72). 30-day mortality was 0 vs. 1.1 % for the CL group and the SL group accordingly (p > 0.99). Conclusions This study comparing short-term surgical outcome and complications after surgical treatment of NSCLC indicates that VATS completion lobectomy after diagnostic wedge resection seems safe when looking at a relatively short time interval between the two procedures.Keywords
Funding Information
- Dr. Fritz Karner and wife Edith Karner Foundation for promoting and optimizing the perioperative patient trajectory.
This publication has 21 references indexed in Scilit:
- Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomyEuropean Journal of Cardio-Thoracic Surgery, 2015
- Modern Management of Thoracic EmpyemaSouthern Medical Journal, 2015
- The early and long-term outcomes of completion pneumonectomy: report of 56 casesInteractive CardioVascular and Thoracic Surgery, 2014
- Invasive adenocarcinoma of the lung is associated with the upper lung regionsLung Cancer, 2014
- Contraindications of video-assisted thoracoscopic surgical lobectomy and determinants of conversion to open2013
- Executive SummarySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2013
- Long-term survival in video-assisted thoracoscopic lobectomy vs open lobectomy in lung-cancer patients: a meta-analysisEuropean Journal of Cardio-Thoracic Surgery, 2013
- Is completion lobectomy merited for unanticipated nodal metastases after radical segmentectomy for cT1 N0 M0/pN1-2 non–small cell lung cancer?The Journal of Thoracic and Cardiovascular Surgery, 2012
- Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials on Safety and Efficacy of Video-Assisted Thoracic Surgery Lobectomy for Early-Stage Non–Small-Cell Lung CancerJournal of Clinical Oncology, 2009
- Predilection of Lung Cancer for the Upper Lobes: An Epidemiologic Inquiry2JNCI Journal of the National Cancer Institute, 1984