Thoracoscopic segmentectomy versus lobectomy: A propensity score-matched analysis.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• Video-assisted thoracic surgery (VATS) has become a standard for lung cancer resection.
• Lobectomy and anatomic segmentectomy are common VATS procedures.
• Comparing their outcomes is crucial for optimizing patient care.

Purpose of the Study:

• To compare postoperative complications, perioperative course, and survival between VATS lobectomy and VATS anatomic segmentectomy.
• To evaluate the safety and efficacy of VATS anatomic segmentectomy versus VATS lobectomy.

Main Methods:

• Retrospective analysis of 2250 patients from the Spanish VATS Group database (Dec 2016-Mar 2018).
• Overall and propensity score-matched analyses were performed.
• Kaplan-Meier and competing risks methods assessed survival.

Main Results:

• VATS anatomic segmentectomy showed lower respiratory complications (RR 0.56, P=.002) and prolonged air leak (RR 0.42, P=.003) in overall analysis.
• Propensity-matched analysis confirmed lower prolonged air leak for VATS anatomic segmentectomy (RR 0.33, P=.02).
• No significant differences in 3-year overall survival, tumor progression mortality, or disease-free survival were observed between groups.

Conclusions:

• VATS anatomic segmentectomy is associated with favorable postoperative outcomes, including reduced complications.
• Midterm survival rates are similar between VATS anatomic segmentectomy and VATS lobectomy.
• VATS anatomic segmentectomy represents a safe and effective alternative to lobectomy.