Is lobectomy by video-assisted thoracic surgery an adequate cancer operation?
| Autor: | Robert McKenna, Peter Wurnig, Matthew Brenner, Richard J. Fischel, Randall K. Wolf |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Time Factors medicine.medical_treatment VATS lobectomy Video Recording Thoracoscopy Carcinoma Humans Medicine Thoracotomy Pneumonectomy Lung cancer Aged Retrospective Studies medicine.diagnostic_test business.industry Endoscopy Retrospective cohort study Length of Stay medicine.disease Survival Analysis Surgery Dissection Carcinoma Bronchogenic Cardiothoracic surgery Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 66:1903-1907 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(98)01166-7 |
| Popis: | Background . Although the public perceives video-assisted thoracic surgery (VATS) as advantageous because it is less invasive than a thoracotomy, the medical community has questioned the safety of VATS lobectomy and its adequacy as a cancer operation. Reported series have not been able to address these issues because follow-up has been only short-term. Methods . A multiinstitutional, retrospective review was performed in 298 consecutive patients who underwent VATS for a standard anatomic lobectomy with lymph node dissection for lung cancer. Pathologic staging was I in 233 (78%), II in 27 (9%), and IIIA in 38 (13%) patients. Kaplan Meier survival analysis was performed. Results . The conversion rate from VATS lobectomy to thoracotomy was 6%, but none were for massive intraoperative bleeding. The only death (0.3%) was because of mesenteric venous thrombosis. Forty minor complications occurred in 38 patients (12.8%) undergoing VATS. The mean and median lengths of stay were 5 ± 3.39 and 4 days, respectively. Recurrence in an incision occurred in 1 patient (0.3%). The Kaplan Meier 4-year survival for stage I was 70% ± 5%. Conclusion . The VATS lobectomy for bronchogenic carcinoma appears to be a safe operation, with the same survival as expected for a lobectomy done by thoracotomy. |
| Databáze: | OpenAIRE |
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