Building a Large Robotic Thoracic Surgery Program in an Emerging Country: Experience in Brazil
| Autor: | Rui Haddad, Carlos Eduardo Teixeira Lima, Leticia Leone Lauricella, Benoit Jacques Bibas, Felipe Braga, Jose Ribas Milanese de Campos, Pedro Henrique Xavier Nabuco de Araujo, Ricardo Mingarini Terra, Paulo Manuel Pêgo-Fernandes, Juliana Mol Trindade |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Thorax
Male medicine.medical_specialty medicine.medical_treatment Operative Time Mediastinal Neoplasms 03 medical and health sciences 0302 clinical medicine Postoperative Complications Robotic Surgical Procedures medicine Humans Robotic surgery Thoracotomy Intraoperative Complications Pneumonectomy Developing Countries Aged Retrospective Studies business.industry Thoracic Surgery Video-Assisted General surgery Thoracic Surgery Retrospective cohort study Vascular surgery Length of Stay Middle Aged Cardiac surgery Cardiothoracic surgery 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Female business Brazil Learning Curve Abdominal surgery |
| Zdroj: | World journal of surgery. 43(11) |
| ISSN: | 1432-2323 |
| Popis: | In the last decade, robotic video-assisted thoracic surgery (R-VATS) has grown significantly and consolidated as an alternative to video-assisted thoracic surgery. The objective of this study is to present the implementation as well as the experience with R-VATS accumulated by 2 Brazilian groups. We also compared the outcomes of procedures performed during the learning curve and after a more mature experience. Retrospective cohort study included all R-VATS procedures performed since April 2015 until April 2018. We describe the process of implantation of robotic surgery, highlighting the peculiarities and difficulties found in a developing country. Moreover, we reported our descriptive results and compared the first 60 patients to the subsequent cases. Two hundred and five patients included 101 females/104 males. Mean age was 61.7 years. There were hundred and sixty-four pulmonary resections, 39 resections of mediastinal lesions, 1 diaphragmatic plication, and 1 resection of a hilar tumor. Median operative times were 205 min for lung resections and 129 min for mediastinal. There was no conversion to VATS or thoracotomy or major intraoperative complications. Median length of stay was 3 days for pulmonary resections and 1 day for mediastinal. Postoperative complications occurred in 35 cases (17.0%)—prolonged air leak was the most common (17 cases). One fatality occurred in an elderly patient with pneumonia and sepsis (0.4%). Comparison of the first 60 patients (learning curve) with subsequent 145 patients (consolidated experience) showed significant differences in surgical and ICU time, both favoring consolidated experience. Our results were comparable to the literature. Robotic thoracic surgery can be safely and successfully implemented in tertiary hospitals in emerging countries provided that all stakeholders are involved and compromised with the implementation process. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink