Subxifoid versus transthoracic thoracoscopic lobectomy: Results of a retrospective analysis before and after matching analysis

Autor: Giacomo Argento, Claudio Andreetti, Mohsen Ibrahim, Antonio Gagliardi, Mario Santini, Valentina Peritore, Alfonso Fiorelli, Erino A. Rendina, Nicola Serra, Giulio Maurizi, Leonardo Teodonio
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
lobectomy
Lung Neoplasms
Visual analogue scale
Matched-Pair Analysis
VATS lobectomy
03 medical and health sciences
0302 clinical medicine
Conventional thoracoscopy
Carcinoma
Non-Small-Cell Lung
medicine
Retrospective analysis
Thoracoscopy
Humans
Lung cancer
Pneumonectomy
RC254-282
Retrospective Studies
medicine.diagnostic_test
business.industry
Thoracic Surgery
Video-Assisted
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
General Medicine
Original Articles
Middle Aged
medicine.disease
Comorbidity
Surgery
subxifoid thoracoscopy
lung cancer
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Propensity score matching
Population study
Original Article
Female
conventional thoracoscopy
business
Zdroj: Thoracic Cancer
Thoracic Cancer, Vol 12, Iss 9, Pp 1279-1290 (2021)
ISSN: 1759-7714
1759-7706
Popis: Background Here, we report our initial experience with subxifoid video‐assisted thoracoscopic surgery (SVATS) lobectomy for the management of primary lung cancer, and compared the outcomes of SVATS with those of conventional transthoracic VATS (CVATS) lobectomies to validate its feasibility and usefulness. Methods The clinical data of consecutive patients undergoing VATS lobectomy via SVATS or CVATS for lung cancer were retrospectively compared. The endpoints were to evaluate the statistical differences in surgical results, postoperative pain (measured with visual analog scale [VAS] scores at 8 hours, Day 1, Day 2, Day 3, at discharge, one month and three months after surgery) and paresthesia (measured at one‐ month, and three months after surgery). The two groups were compared before and after matching analysis. Results Our study population included 223 patients: 84 in the SVATS and 139 in the CVATS group. The two groups were not comparable for sex (P = 0.001), preoperative comorbidity as cardiopathy (P = 0.007), BMI value (P = 0.003), left‐sided procedure (P = 0.04), tumor stage (P = 0.04), and tumor size (P = 0.002). These differences were overcome by propensity score matching (PSM) analysis that yielded two well‐matched groups which included 61 patients in each group. Surgical outcomes including blood loss, hospital stay and complications were similar before and after matching analysis, but SVATS compared to CVATS was associated with longer operative time before (159 ± 13 vs. 126 ± 6.3, P
Subxifoid thoracoscopy is a safe procedure compared to conventional transthoracic thoracoscopy. It avoids intercostal incision and spares nerve trauma, resulting in a reduction of postoperative pain and paresthesia.
Databáze: OpenAIRE
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