Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study)

Abstract

Objective: The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil. Methods: Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy. Demographic, surgical, and postoperative data were collected with a standardized instrument, after which they were compiled and analyzed. Results: The surgeons provided data related to a collective total of 786 patients (mean number of resections per surgeon, 43.6). However, 137 patients were excluded because some data were missing. Therefore, the study sample comprised 649 patients. The mean age of the patients was 61.7 years. Of the 649 patients, 295 (45.5%) were male. The majority-521 (89.8%)-had undergone surgery for neoplasia, which was most often classified as stage IA. The median duration of pleural drainage was 3 days, and the median hospital stay was 4 days. Of the 649 procedures evaluated, 598 (91.2%) were lobectomies. Conversion to thoracotomy was necessary in 30 cases (4.6%). Postoperative complications occurred in 124 patients (19.1%), the most common complications being pneumonia, prolonged air leaks, and atelectasis. The 30-day mortality rate was 2.0%, advanced age and diabetes being found to be predictors of mortality. Conclusions: Our analysis of this representative sample of patients undergoing pulmonary resection by video-assisted thoracoscopy in Brazil showed that the procedure is practicable and safe, as well as being comparable to those performed in other countries.

Robotic thoracic surgery for non-small cell lung cancer: initial experience in Brazil

“…Another study using the SBCT database, which included pulmonary resections by video-assisted thoracoscopic surgery, reported a surgical morbidity rate of 19.1% and a mortality rate of 2.0%. (2) In our study, morbidity is comparable to that in patients who underwent video-assisted thoracoscopic surgery. However, there was a significant reduction in postoperative mortality (1.6-2.0% vs. 0.5%).…”

“…In the last two decades, minimally invasive surgery has been established as the gold standard for the treatment of lung cancer. (1,2) Several studies have been published and confirmed the role of video-assisted thoracoscopic surgery in complex resections such as lobectomies and pneumonectomies. (3,4) Recently, robotic surgery has emerged as an alternative to conventional video-assisted thoracoscopic surgery, because it has the advantage of increasing the amplitude and precision of intracavitary maneuvers and movements, as well as improving visualization through three-dimensional imaging.…”

Persistant Hemothorax after Video-Assisted Thoracoscopic Surgery Secondary to Factor V Deficiency

“…Video-assisted thoracoscopic surgery (VATS) has become a standard therapeutic modality for spontaneous pneumothorax, diagnostic biopsies for multiple pulmonary and pleural diseases [4,5], management of complicated pleural effusions and, for major resections of pulmonary masses with a much lower rate of complications than open thoracotomy [6,7]. VATS bleeding complications has been reported as low as 0.6%, the majority of which are mild and " in layers" to 4.3% in major resections due to vascular injuries in 50% of the cases [8]. In the actual case, VATS was performed for a pleural effusion drainage and biopsy with a presumptive diagnosis of pleural tuberculosis, having no trans-operative complications.…”

Thymic minimally invasive surgery: state of the art across the world: Central-South America

“…There was a big-time lapse since those first initial experiences until the publication of a large series of anatomic lung resections in Brazil (13). In that paper, the authors reported the outcomes of 649 major lung resections performed by 18 thoracic surgeons from 14 institutions from different parts of the country.…”