Tags

Type your tag names separated by a space and hit enter

The safe transition from open to thoracoscopic lobectomy: a 5-year experience.
Ann Thorac Surg. 2009 Jul; 88(1):216-25; discussion 225-6.AT

Abstract

BACKGROUND

We hypothesized that established thoracic surgeons without formal minimally invasive training can learn thoracoscopic lobectomy without compromising patient safety or outcome.

METHODS

Data were retrospectively collected on patients who underwent pulmonary lobectomy at a single health system between August 1, 2003, and April 1, 2008. Age, sex, pulmonary function tests, preoperative and postoperative stages, pathologic diagnosis, anatomic resection, extent of lymph node sampling, surgical technique and duration, complications, blood loss, transfusion requirement, chest tube duration, length of hospital stay, 30-day readmission, and mortality rate were examined. The percentage of patients who underwent thoracoscopic lobectomy and their outcomes were then compared among three chronologic cohorts.

RESULTS

Three hundred sixty-four patients underwent pulmonary lobectomy (239 open; 99 thoracoscopic; 26 thoracoscopic converted to open). Baseline characteristics, staging, pathologic diagnosis, and anatomic resections were similar in the early, middle, and late cohorts. The percentage of thoracoscopic lobectomies increased from 16% to 49%, whereas open lobectomy decreased from 81% to 42% (p < 0.0001). The complication rate remained constant with the exception of air leaks lasting more than 7 days (9% versus 10% versus 2%; p = 0.02). Hospital length of stay (6 versus 5 versus 4 days; p < 0.0001) and chest tube duration (4 versus 3 versus 3 days; p < 0.0001) decreased and operative duration increased as more thoracoscopic lobectomies were performed. Blood loss, transfusion requirement, 30-day readmission, and 1-year survival were not significantly different among chronologic cohorts.

CONCLUSIONS

Established thoracic surgeons can safely incorporate thoracoscopic lobectomy with no increase in morbidity or mortality.

Authors+Show Affiliations

Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan, USA.No 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

19559229

Citation

Seder, Christopher W., et al. "The Safe Transition From Open to Thoracoscopic Lobectomy: a 5-year Experience." The Annals of Thoracic Surgery, vol. 88, no. 1, 2009, pp. 216-25; discussion 225-6.
Seder CW, Hanna K, Lucia V, et al. The safe transition from open to thoracoscopic lobectomy: a 5-year experience. Ann Thorac Surg. 2009;88(1):216-25; discussion 225-6.
Seder, C. W., Hanna, K., Lucia, V., Boura, J., Kim, S. W., Welsh, R. J., & Chmielewski, G. W. (2009). The safe transition from open to thoracoscopic lobectomy: a 5-year experience. The Annals of Thoracic Surgery, 88(1), 216-25; discussion 225-6. https://doi.org/10.1016/j.athoracsur.2009.04.017
Seder CW, et al. The Safe Transition From Open to Thoracoscopic Lobectomy: a 5-year Experience. Ann Thorac Surg. 2009;88(1):216-25; discussion 225-6. PubMed PMID: 19559229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The safe transition from open to thoracoscopic lobectomy: a 5-year experience. AU - Seder,Christopher W, AU - Hanna,Kenny, AU - Lucia,Victoria, AU - Boura,Judith, AU - Kim,Sang W, AU - Welsh,Robert J, AU - Chmielewski,Gary W, PY - 2008/11/08/received PY - 2009/03/31/revised PY - 2009/04/02/accepted PY - 2009/6/30/entrez PY - 2009/6/30/pubmed PY - 2009/8/6/medline SP - 216-25; discussion 225-6 JF - The Annals of thoracic surgery JO - Ann. Thorac. Surg. VL - 88 IS - 1 N2 - BACKGROUND: We hypothesized that established thoracic surgeons without formal minimally invasive training can learn thoracoscopic lobectomy without compromising patient safety or outcome. METHODS: Data were retrospectively collected on patients who underwent pulmonary lobectomy at a single health system between August 1, 2003, and April 1, 2008. Age, sex, pulmonary function tests, preoperative and postoperative stages, pathologic diagnosis, anatomic resection, extent of lymph node sampling, surgical technique and duration, complications, blood loss, transfusion requirement, chest tube duration, length of hospital stay, 30-day readmission, and mortality rate were examined. The percentage of patients who underwent thoracoscopic lobectomy and their outcomes were then compared among three chronologic cohorts. RESULTS: Three hundred sixty-four patients underwent pulmonary lobectomy (239 open; 99 thoracoscopic; 26 thoracoscopic converted to open). Baseline characteristics, staging, pathologic diagnosis, and anatomic resections were similar in the early, middle, and late cohorts. The percentage of thoracoscopic lobectomies increased from 16% to 49%, whereas open lobectomy decreased from 81% to 42% (p < 0.0001). The complication rate remained constant with the exception of air leaks lasting more than 7 days (9% versus 10% versus 2%; p = 0.02). Hospital length of stay (6 versus 5 versus 4 days; p < 0.0001) and chest tube duration (4 versus 3 versus 3 days; p < 0.0001) decreased and operative duration increased as more thoracoscopic lobectomies were performed. Blood loss, transfusion requirement, 30-day readmission, and 1-year survival were not significantly different among chronologic cohorts. CONCLUSIONS: Established thoracic surgeons can safely incorporate thoracoscopic lobectomy with no increase in morbidity or mortality. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/19559229/The_safe_transition_from_open_to_thoracoscopic_lobectomy:_a_5_year_experience_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(09)00646-8 DB - PRIME DP - Unbound Medicine ER -