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Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications.
Ann Thorac Surg. 2008 Jan; 85(1):231-5; discussion 235-6.AT

Abstract

BACKGROUND

The purpose of this study was to determine if the utilization of video-assisted thoracic surgery (VATS) for lobectomy for clinical stage I non-small cell lung cancer in elderly patients results in decreased complications compared with lobectomy by thoracotomy (THOR).

METHODS

A retrospective, matched case-control study was performed evaluating the perioperative outcomes after lobectomy by VATS versus THOR performed in elderly patients (age > or = 70 years) at a single institution. All complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0 (http://ctep.cancer.gov/reporting/ctc.html).

RESULTS

Between May 1, 2002 and December 31, 2005 333 patients (245 THOR, 88 VATS) 70 years old or greater underwent lobectomy for clinical stage I non-small cell lung cancer. After matching based on age, gender, presence of comorbid conditions, and preoperative clinical stage, there were 82 patients in each group. Patients had similar preoperative characteristics. A VATS approach resulted in a significantly lower rate of complications compared with THOR (28% vs 45%, p = 0.04) and a shorter median length of stay (5 days, range 2 to 20 vs 6 days, range 2 to 27, p < 0.001). No patients undergoing VATS lobectomy had higher than grade 2 complications, whereas 7% of complications in the THOR group were grade 3 or higher. There were no perioperative deaths in the VATS patients compared with an in-hospital mortality rate of 3.6% (3 of 82) for THOR patients.

CONCLUSIONS

A VATS approach to lobectomy for clinical stage I non-small cell lung cancer in the elderly was associated with fewer and overall reduced severity of complications as well as a shorter hospital stay compared with thoracotomy.

Authors+Show Affiliations

Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18154816

Citation

Cattaneo, Stephen M., et al. "Use of Video-assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications." The Annals of Thoracic Surgery, vol. 85, no. 1, 2008, pp. 231-5; discussion 235-6.
Cattaneo SM, Park BJ, Wilton AS, et al. Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008;85(1):231-5; discussion 235-6.
Cattaneo, S. M., Park, B. J., Wilton, A. S., Seshan, V. E., Bains, M. S., Downey, R. J., Flores, R. M., Rizk, N., & Rusch, V. W. (2008). Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. The Annals of Thoracic Surgery, 85(1), 231-5; discussion 235-6.
Cattaneo SM, et al. Use of Video-assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications. Ann Thorac Surg. 2008;85(1):231-5; discussion 235-6. PubMed PMID: 18154816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. AU - Cattaneo,Stephen M, AU - Park,Bernard J, AU - Wilton,Andrew S, AU - Seshan,Venkatraman E, AU - Bains,Manjit S, AU - Downey,Robert J, AU - Flores,Raja M, AU - Rizk,Nabil, AU - Rusch,Valerie W, PY - 2007/01/30/received PY - 2007/07/24/revised PY - 2007/07/24/accepted PY - 2007/12/25/pubmed PY - 2008/1/26/medline PY - 2007/12/25/entrez SP - 231-5; discussion 235-6 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 85 IS - 1 N2 - BACKGROUND: The purpose of this study was to determine if the utilization of video-assisted thoracic surgery (VATS) for lobectomy for clinical stage I non-small cell lung cancer in elderly patients results in decreased complications compared with lobectomy by thoracotomy (THOR). METHODS: A retrospective, matched case-control study was performed evaluating the perioperative outcomes after lobectomy by VATS versus THOR performed in elderly patients (age > or = 70 years) at a single institution. All complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0 (http://ctep.cancer.gov/reporting/ctc.html). RESULTS: Between May 1, 2002 and December 31, 2005 333 patients (245 THOR, 88 VATS) 70 years old or greater underwent lobectomy for clinical stage I non-small cell lung cancer. After matching based on age, gender, presence of comorbid conditions, and preoperative clinical stage, there were 82 patients in each group. Patients had similar preoperative characteristics. A VATS approach resulted in a significantly lower rate of complications compared with THOR (28% vs 45%, p = 0.04) and a shorter median length of stay (5 days, range 2 to 20 vs 6 days, range 2 to 27, p < 0.001). No patients undergoing VATS lobectomy had higher than grade 2 complications, whereas 7% of complications in the THOR group were grade 3 or higher. There were no perioperative deaths in the VATS patients compared with an in-hospital mortality rate of 3.6% (3 of 82) for THOR patients. CONCLUSIONS: A VATS approach to lobectomy for clinical stage I non-small cell lung cancer in the elderly was associated with fewer and overall reduced severity of complications as well as a shorter hospital stay compared with thoracotomy. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/18154816/Use_of_video_assisted_thoracic_surgery_for_lobectomy_in_the_elderly_results_in_fewer_complications_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(07)01611-6 DB - PRIME DP - Unbound Medicine ER -