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Thoracoscopic sublobar resections (TSLRs) have a concerning rate of unplanned procedures, though lower than lobectomies. Improved preoperative planning may reduce these events in lung cancer surgery.

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Thoracoscopic sublobar resections (TSLRs) are increasingly utilized but technically demanding.
  • Despite challenges, TSLRs report low adverse events, creating a paradox.
  • This study investigates the safety and outcomes of a TSLR series.

Purpose of the Study:

  • To analyze the rate of unplanned procedures in thoracoscopic anatomical segmentectomies.
  • To identify reasons for unplanned thoracotomies and additional resections.
  • To assess the safety of TSLRs in lung cancer patients.

Main Methods:

  • Review of a prospective database of videothoracoscopic anatomical resections.
  • Inclusion of all planned thoracoscopic segmentectomies from January 2007 to July 2016.
  • Analysis of intraoperative and postoperative data, defining unplanned procedures as conversion to thoracotomy or additional resection.

Main Results:

  • 284 thoracoscopic anatomical segmentectomies were performed in 280 patients.
  • 8% of patients (23/284) experienced an unplanned procedure.
  • Unplanned thoracotomies occurred in 3.1% and unplanned additional resections in 5.1%.

Conclusions:

  • The rate of unplanned procedures during TSLRs warrants attention, despite being lower than for thoracoscopic lobectomies.
  • Technical refinements, particularly enhanced preoperative planning, could potentially decrease unplanned procedures.
  • TSLRs demonstrate a 3% unplanned additional resection rate for oncological reasons in lung cancer cases.