Report from the European Society of Thoracic Surgeons database 2019: current surgical practice and perioperative outcomes of pulmonary metastasectomy.

Details

Serval ID
serval:BIB_F7C352B0313F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Report from the European Society of Thoracic Surgeons database 2019: current surgical practice and perioperative outcomes of pulmonary metastasectomy.
Journal
European journal of cardio-thoracic surgery
Author(s)
Gonzalez M., Brunelli A., Szanto Z., Passani S., Falcoz P.E.
ISSN
1873-734X (Electronic)
ISSN-L
1010-7940
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
We report an overview of surgical practices and outcomes in patients undergoing pulmonary metastasectomy based on data from the European Society of Thoracic Surgeons database.
We retrieved data on resections performed for pulmonary metastases between July 2007 and July 2019. We evaluated baseline characteristics, surgical management and postoperative outcomes. Open and video-assisted thoracic surgery (VATS) procedures were compared in terms of surgical management, morbidity and mortality.
We selected 8868 patients [male/female 5031/3837; median age: 64 years (interquartile range 55-71)] who underwent pulmonary metastasectomy. Surgical approach consisted of open thoracotomy in 63.5% of cases (n = 5627) and VATS in 36.5% (n = 3241), with a conversion rate of 2.1% (n = 69). Surgical resection was managed by wedge or local excision in 61% (n = 5425) of cases and anatomical resection in 39% (n = 3443); lobectomy: 26% (n = 2307); segmentectomy: 11% (n = 949); bilobectomy: 1% (n = 95); pneumonectomy: 1% (n = 92)). Lymph node assessment was realized in 58% (n = 5097) [sampling: 21% (n = 1832); complete dissection: 37% (n = 3265)]. Overall morbidity and mortality rates were 15% (n = 1308) and 0.8% (n = 69), respectively. Median duration of stay was 6 days (interquartile range 4-8). The rate of VATS procedures increased from 15% in 2007 to 58% in 2018. When comparing VATS and Open surgery, there were significantly (P < 0.001) fewer anatomical resections by VATS (24% vs 49%), lymph node assessments (36% vs 70%), less morbidity (9% vs 18%) and shorter durations of stay (median: 4 vs 7 days).
We report a good overview of current surgical practices in terms of resection extent and postoperative outcomes with a gradual acceptance of VATS.
Keywords
Lymph node dissection, Pulmonary metastasectomy, Pulmonary resection, Video-assisted thoracic surgery
Pubmed
Create date
26/11/2020 23:39
Last modification date
17/04/2021 6:34
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