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Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer.
Ann Thorac Surg. 2007 Jun; 83(6):1965-70.AT

Abstract

BACKGROUND

Lobectomy for patients with clinical stage I non-small cell lung cancer (NSCLC) can be performed by thoracotomy or by video-assisted thoracoscopic surgery (VATS). We compared the operative characteristics and postoperative course for patients with clinical stage I NSCLC who underwent lobectomy by VATS or thoracotomy.

METHODS

We retrospectively reviewed the charts of all patients undergoing lobectomy for clinical stage I NSCLC from January 1, 1998, through June 30, 2005.

RESULTS

We performed 147 lobectomies (88 thoracotomy, 59 VATS) in 147 patients with clinical stage I NSCLC. Patient demographics were similar between groups; however, VATS patients had more hypertension (p = 0.0114), chronic renal insufficiency (p = 0.0479), and previous malignancies (p = 0.0086). The two groups did not differ in pathologic stage, tumor size, histologic results, or number of positive nodes. More total nodes were identified in thoracotomy patients (p = 0.0001), and they had a shorter intensive care unit stay (p = 0.0224). VATS patients had significantly less postoperative pneumonia (p = 0.0023). VATS patients trended toward fewer chest tube days and a shorter hospital length of stay. The two groups did not differ in operative time, blood loss, atrial fibrillation, or number of ventilator days. Median survival between the cohorts was similar (>7.9 years thoracotomy versus >4.6 years VATS, log-rank p = 0.6939).

CONCLUSIONS

Patients undergoing VATS lobectomy for clinical stage I NSCLC, despite having more comorbidities, had fewer postoperative complications. The approaches are equivalent in operative time, blood loss, length of stay, and survival rate. Compared with thoracotomy, VATS lobectomy for patients with clinical stage I NSCLC appears to be a less morbid operation.

Authors+Show Affiliations

Department of Surgery, Section of Thoracic and Foregut Surgery, University of Minnesota Medical Center, Minneapolis, Minnesota 55455, USA. bwhit@umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17532379

Citation

Whitson, Bryan A., et al. "Video-assisted Thoracoscopic Surgery Is More Favorable Than Thoracotomy for Resection of Clinical Stage I Non-small Cell Lung Cancer." The Annals of Thoracic Surgery, vol. 83, no. 6, 2007, pp. 1965-70.
Whitson BA, Andrade RS, Boettcher A, et al. Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer. Ann Thorac Surg. 2007;83(6):1965-70.
Whitson, B. A., Andrade, R. S., Boettcher, A., Bardales, R., Kratzke, R. A., Dahlberg, P. S., & Maddaus, M. A. (2007). Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer. The Annals of Thoracic Surgery, 83(6), 1965-70.
Whitson BA, et al. Video-assisted Thoracoscopic Surgery Is More Favorable Than Thoracotomy for Resection of Clinical Stage I Non-small Cell Lung Cancer. Ann Thorac Surg. 2007;83(6):1965-70. PubMed PMID: 17532379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer. AU - Whitson,Bryan A, AU - Andrade,Rafael S, AU - Boettcher,Adam, AU - Bardales,Ricardo, AU - Kratzke,Robert A, AU - Dahlberg,Peter S, AU - Maddaus,Michael A, PY - 2006/10/30/received PY - 2007/01/22/revised PY - 2007/01/23/accepted PY - 2007/5/29/pubmed PY - 2007/6/9/medline PY - 2007/5/29/entrez SP - 1965 EP - 70 JF - The Annals of thoracic surgery JO - Ann. Thorac. Surg. VL - 83 IS - 6 N2 - BACKGROUND: Lobectomy for patients with clinical stage I non-small cell lung cancer (NSCLC) can be performed by thoracotomy or by video-assisted thoracoscopic surgery (VATS). We compared the operative characteristics and postoperative course for patients with clinical stage I NSCLC who underwent lobectomy by VATS or thoracotomy. METHODS: We retrospectively reviewed the charts of all patients undergoing lobectomy for clinical stage I NSCLC from January 1, 1998, through June 30, 2005. RESULTS: We performed 147 lobectomies (88 thoracotomy, 59 VATS) in 147 patients with clinical stage I NSCLC. Patient demographics were similar between groups; however, VATS patients had more hypertension (p = 0.0114), chronic renal insufficiency (p = 0.0479), and previous malignancies (p = 0.0086). The two groups did not differ in pathologic stage, tumor size, histologic results, or number of positive nodes. More total nodes were identified in thoracotomy patients (p = 0.0001), and they had a shorter intensive care unit stay (p = 0.0224). VATS patients had significantly less postoperative pneumonia (p = 0.0023). VATS patients trended toward fewer chest tube days and a shorter hospital length of stay. The two groups did not differ in operative time, blood loss, atrial fibrillation, or number of ventilator days. Median survival between the cohorts was similar (>7.9 years thoracotomy versus >4.6 years VATS, log-rank p = 0.6939). CONCLUSIONS: Patients undergoing VATS lobectomy for clinical stage I NSCLC, despite having more comorbidities, had fewer postoperative complications. The approaches are equivalent in operative time, blood loss, length of stay, and survival rate. Compared with thoracotomy, VATS lobectomy for patients with clinical stage I NSCLC appears to be a less morbid operation. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/17532379/Video_assisted_thoracoscopic_surgery_is_more_favorable_than_thoracotomy_for_resection_of_clinical_stage_I_non_small_cell_lung_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(07)00219-6 DB - PRIME DP - Unbound Medicine ER -