Video-assisted thoracoscopic surgery lobectomy at 20 years: a consensus statement.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Video-assisted thoracoscopic surgery (VATS) lobectomy is an established alternative to open thoracotomy for non-small-cell lung cancer (NSCLC).
• Standardization of perioperative management for VATS lobectomy is needed to optimize patient outcomes.
• Expert consensus is crucial for establishing best practices in complex surgical procedures.

Purpose of the Study:

• To standardize the perioperative management of VATS lobectomy patients.
• To provide evidence-based guidance for clinical practice.
• To consolidate expert opinion on VATS lobectomy after 20 years of experience.

Main Methods:

• A Delphi methodology was employed with a panel of 55 international VATS lobectomy experts.
• Two rounds of voting were conducted to reach consensus on key aspects of VATS lobectomy.
• Consensus was defined as >50% agreement; recommendations were 'recommended' (50-74%) or 'highly recommended' (≥75%).

Main Results:

• Fifty experts (91%) from 16 countries participated, completing both voting rounds.
• Consensus was achieved on 21 controversial points regarding VATS lobectomy.
• Key areas of consensus included definition, indications, contraindications, perioperative management, and training.

Conclusions:

• The Consensus Statement reflects collective agreement among experts on standardized VATS lobectomy practices.
• This initiative aims to guide the thoracic surgical community in optimizing VATS lobectomy.
• The consensus provides a foundation for future research and refinement of VATS lobectomy techniques.