Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience.

Details

Serval ID
serval:BIB_172CBB5657F1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience.
Journal
Journal of thoracic disease
Author(s)
Bédat B., Abdelnour-Berchtold E., Krueger T., Perentes J.Y., Ris H.B., Triponez F., Licker M.J., Karenovics W., Gonzalez M.
ISSN
2072-1439 (Print)
ISSN-L
2072-1439
Publication state
Published
Issued date
08/2018
Peer-reviewed
Oui
Volume
10
Number
8
Pages
5023-5029
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Pulmonary anatomical segmentectomies are increasingly being done via video-assisted thoracoscopic surgery (VATS). We analyzed clinical outcomes and risk factors for post-operative complications after pulmonary segmentectomy by VATS was introduced in two institutions.
We retrospectively reviewed records of all patients who underwent anatomical pulmonary segmentectomy by VATS from 2014 to 2016 at the university hospitals of Geneva and Lausanne in Switzerland.
One hundred twenty-nine patients (64 men; median age 68 years, range, 29-85 years) underwent anatomical VATS segmentectomy for primary lung tumors (n=100), metastases (n=16) and benign lesions (n=13). The overall 30-day mortality and morbidity rates were 0.8% and 31%, respectively. The reoperation rate was 4.7% [indications: hemothorax 2, prolonged air leak (PAL) 2, segmental torsion 1, empyema 1]. Chest drainage lasted for a median of 2 days (range, 1-33 days) and patients were discharged from the hospital after a median of 6 days (range, 2-37 days). Postoperative complications were mainly associated with chronic obstructive pulmonary disease (COPD) [odds ratio (OR) 2.54 and 95% confidence interval (95% CI), 1.18-5.47], and smoking pack-years >50 units (OR 5.27; 95% CI, 1.68-16.55). Nine patients (9%) presented with distant recurrences. Nodule size >2 cm was associated with decreased disease-free survival (DFS) (P=0.04). There was no association between surgical experience in VATS segmentectomy and DFS or postoperative complications.
Segmentectomies can be safely performed by VATS in an initial experience and result in favorable clinical outcome. COPD and smoking pack-years are associated with an increased risk of complications.
Keywords
Pulmonary segmentectomy, complications, lung cancer, thoracoscopy
Pubmed
Web of science
Create date
24/09/2018 12:07
Last modification date
20/08/2019 13:46
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