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Five-Year Experience with VATS Versus Thoracotomy Segmentectomy for Lung Tumor Resection
Michel J Sabra1, Yahya Alwatari1, Christine Bierema1
16887 Division of Cardiothoracic Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Innovations (Philadelphia, Pa.)
|July 29, 2020
Summary
Video-assisted thoracoscopic surgery (VATS) segmentectomy offers better outcomes than thoracotomy, with fewer complications and shorter hospital stays. This study highlights VATS segmentectomy
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Minimally Invasive Procedures
Background:
- Segmentectomy is a lung cancer surgical approach.
- Video-assisted thoracoscopic surgery (VATS) and thoracotomy are common methods.
- A comparative multicenter study is needed.
Purpose of the Study:
- Compare 30-day surgical outcomes of VATS versus thoracotomy for segmentectomy.
- Utilize a large national database for analysis.
- Evaluate perioperative outcomes and complications.
Main Methods:
- Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database (2013-2017).
- Included patients undergoing segmentectomy for tumors.
- Propensity-matched analysis comparing VATS and thoracotomy groups, with VATS further divided into early and late subgroups.
Main Results:
- VATS segmentectomy showed shorter hospital stays (3.9 vs 5.8 days) and higher home discharge rates (94% vs 89%) compared to thoracotomy.
- VATS was linked to significantly lower rates of postoperative pneumonia, unplanned intubation, prolonged intubation, transfusion requirements, and deep venous thrombosis.
- The later VATS group (2016-2017) demonstrated fewer cardiac arrests and shorter hospital stays than the earlier VATS group (2013-2015).
Conclusions:
- VATS segmentectomy is associated with fewer postoperative complications and reduced hospital length of stay compared to thoracotomy.
- The adoption of VATS segmentectomy is increasing, accompanied by improved patient outcomes.
- VATS represents a safer and more efficient approach for lung segmentectomy.
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