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Video-assisted thoracoscopic lobectomy: state of the art and future directions.
Ann Thorac Surg. 2008 Feb; 85(2):S705-9.AT

Abstract

BACKGROUND

Thoracoscopic lobectomy is performed with increasing frequency for early-stage lung cancer. Several published reports suggest thoracoscopic resection is safe, with the potential advantage of shorter hospital stay, quicker recovery, and comparable oncologic results.

METHODS

Data on 180 video-assisted thoracoscopic surgery (VATS) patients who underwent thoracoscopic lobectomy or sublobar anatomic resection at our institution between January 2002 and December 2006 were reviewed. The conversion rate to thoracotomy, complications, length of stay, and duration of chest tube drainage were determined. Similar variables were evaluated for patients aged older than 80 years, those with a forced expiratory volume in 1 second (FEV1) that was less than 50% predicted, those who had undergone preoperative neoadjuvant therapy, and those who had undergone lung-sparing anatomic resections.

RESULTS

Thoracoscopic anatomic lung resection was performed successfully in 166 patients. One of 180 patients (0.6%) died, and 14 patients (9.2%) underwent conversions. Overall median length of stay was 4 days (range, 1 to 98; interquartile range [IQR], 3), and median duration of chest tube drainage was 3 days (range, 0 to 35 days; IQR, 2). The median length of hospital stay and median chest tube duration for the group aged 80 years and older was 5 and 3 days; for the segmental resection group, 4 and 3 days; for the chemotherapy or radiotherapy induction group, 3.5 and 3 days; and for the FEV1 less than 50% group, 5.5 and 4 days, respectively. No patients died in any of these groups.

CONCLUSIONS

Thoracoscopic lung resection can be performed safely in selected patients aged 80 years and older, in those with marginal pulmonary function, and in those with pathologic response to neoadjuvant therapy.

Authors+Show Affiliations

Division of Thoracic Surgery, The Mount Sinai Medical Center, New York, New York 10029, USA.No 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
Review

Language

eng

PubMed ID

18222201

Citation

Shaw, Jason P., et al. "Video-assisted Thoracoscopic Lobectomy: State of the Art and Future Directions." The Annals of Thoracic Surgery, vol. 85, no. 2, 2008, pp. S705-9.
Shaw JP, Dembitzer FR, Wisnivesky JP, et al. Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac Surg. 2008;85(2):S705-9.
Shaw, J. P., Dembitzer, F. R., Wisnivesky, J. P., Litle, V. R., Weiser, T. S., Yun, J., Chin, C., & Swanson, S. J. (2008). Video-assisted thoracoscopic lobectomy: state of the art and future directions. The Annals of Thoracic Surgery, 85(2), S705-9. https://doi.org/10.1016/j.athoracsur.2007.11.048
Shaw JP, et al. Video-assisted Thoracoscopic Lobectomy: State of the Art and Future Directions. Ann Thorac Surg. 2008;85(2):S705-9. PubMed PMID: 18222201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Video-assisted thoracoscopic lobectomy: state of the art and future directions. AU - Shaw,Jason P, AU - Dembitzer,Francine R, AU - Wisnivesky,Juan P, AU - Litle,Virginia R, AU - Weiser,Todd S, AU - Yun,Jaime, AU - Chin,Cynthia, AU - Swanson,Scott J, PY - 2007/09/20/received PY - 2007/11/12/revised PY - 2007/11/14/accepted PY - 2008/1/29/pubmed PY - 2008/3/12/medline PY - 2008/1/29/entrez SP - S705 EP - 9 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 85 IS - 2 N2 - BACKGROUND: Thoracoscopic lobectomy is performed with increasing frequency for early-stage lung cancer. Several published reports suggest thoracoscopic resection is safe, with the potential advantage of shorter hospital stay, quicker recovery, and comparable oncologic results. METHODS: Data on 180 video-assisted thoracoscopic surgery (VATS) patients who underwent thoracoscopic lobectomy or sublobar anatomic resection at our institution between January 2002 and December 2006 were reviewed. The conversion rate to thoracotomy, complications, length of stay, and duration of chest tube drainage were determined. Similar variables were evaluated for patients aged older than 80 years, those with a forced expiratory volume in 1 second (FEV1) that was less than 50% predicted, those who had undergone preoperative neoadjuvant therapy, and those who had undergone lung-sparing anatomic resections. RESULTS: Thoracoscopic anatomic lung resection was performed successfully in 166 patients. One of 180 patients (0.6%) died, and 14 patients (9.2%) underwent conversions. Overall median length of stay was 4 days (range, 1 to 98; interquartile range [IQR], 3), and median duration of chest tube drainage was 3 days (range, 0 to 35 days; IQR, 2). The median length of hospital stay and median chest tube duration for the group aged 80 years and older was 5 and 3 days; for the segmental resection group, 4 and 3 days; for the chemotherapy or radiotherapy induction group, 3.5 and 3 days; and for the FEV1 less than 50% group, 5.5 and 4 days, respectively. No patients died in any of these groups. CONCLUSIONS: Thoracoscopic lung resection can be performed safely in selected patients aged 80 years and older, in those with marginal pulmonary function, and in those with pathologic response to neoadjuvant therapy. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/18222201/Video_assisted_thoracoscopic_lobectomy:_state_of_the_art_and_future_directions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(07)02397-1 DB - PRIME DP - Unbound Medicine ER -