Perioperative Outcomes and 5-year Survival After Open versus Thoracoscopic Sleeve Resection for Lung Cancer

Mayne, Nicholas R.; Darling, Alice J.; Raman, Vignesh; Balderson, Stafford S.; Berry, Mark F.; Harpole, David H.; D’Amico, Thomas A.; Yang, Chi‐Fu Jeffrey

doi:10.1053/j.semtcvs.2020.08.013

Cited by 9 publications

(11 citation statements)

References 17 publications

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“…Ultimately, six studies reporting on 655 patients undergoing bronchial sleeve lobectomy for NSCLC (229 VATS and 426 open) fulfilled the inclusion criteria and were included in our quantitative data synthesis 12,24–28 (Figure 1). Five of those studies were from China 12,25–28 and one from the United States; 24 three studies were published in 2020 12,24,25 (Table 1). An additional study that fulfilled our inclusion criteria was identified, but was ultimately excluded due to overlapping populations.…”

Section: Resultsmentioning

confidence: 99%

“…Through our systematic search, 1866 unique articles were retrieved, of which 124 underwent full-text evaluation for eligibility. Ultimately, six studies reporting on 655 patients undergoing bronchial sleeve lobectomy for NSCLC (229 VATS and 426 open) fulfilled the inclusion criteria and were included in our quantitative data synthesis 12,24–28 (Figure 1). Five of those studies were from China 12,25–28 and one from the United States; 24 three studies were published in 2020 12,24,25 (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Patients having VATS sleeve lung resection converted to open may be included in the open or VATS group. Two out of six included studies 24,25 include the VATS converted to open sleeve patients to the VATS group. These may increase the participant selection associated bias.…”

Section: Discussionmentioning

confidence: 99%

“…29 Baseline patient characteristics including demographics, preoperative lung function, and tumor characteristics were comparable between the two groups (Table 2). Three studies used the seventh 24,25,27 and three studies the eighth edition 12,26,28 of the TNM classification system.…”

Section: Study Selection and Patient Characteristicsmentioning

confidence: 99%

“…We assessed the individual risk of bias of included studies using the ROBINS-I tool. The overall risk of bias was determined to be moderate in four studies 12,[24][25][26] and serious in two studies. 27,28 No studies were found to be at critical risk of bias (Figure 2).…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Video-assisted thoracoscopic versus open sleeve lobectomy for non-small cell lung cancer: A systematic review and meta-analysis from six comparative studies

Geropoulos

Esagian²,

Skarentzos³

et al. 2022

Asian Cardiovasc Thorac Ann

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Background Lung sleeve resection is indicated for centrally located lung tumors, especially for patients who cannot tolerate pneumonectomy. With video-assisted thoracoscopic surgery (VATS) being increasingly implemented for a wide variety of thoracic pathologies, this study aims to compare the intraoperative, postoperative, and long-term outcomes of VATS and open bronchial sleeve lobectomy for non-small cell lung cancer (NSCLC). Methods The MEDLINE (via PubMed), Cochrane Library, and Scopus databases were searched. Original clinical studies, comparing VATS and open sleeve lobectomy for NSCLC were included. Evidence was synthesized as odds ratios for categorical and weighted mean difference (WMD) for continuous variables. Results Our analysis included six studies with non-overlapping populations reporting on 655 patients undergoing bronchial sleeve lobectomy for NSCLC (229 VATS and 426 open). VATS sleeve lobectomy was associated with significantly longer operative time ((WMD): 45.85 min, 95% confidence interval (CI): 12.06 to 79.65, p = 0.01) but less intraoperative blood loss ((WMD): −34.57 mL, 95%CI: −58.35 to −10.78, p < 0.001). No significant difference was found between VATS and open bronchial sleeve lobectomy in margin-negative resection rate, number of lymph nodes resected, postoperative outcomes (drainage duration, length of hospital stay, 30-day mortality), postoperative complications (pneumonia, bronchopleural fistula/empyema, prolonged air leakage, chylothorax, pulmonary embolism, and arrhythmia), and long-term outcomes (overall survival, recurrence-free survival). Conclusions The limitation of our study arises mainly due to the heterogeneity of the included studies. Nevertheless, VATS bronchial sleeve lung resection constitutes a feasible and safe alternative to the open sleeve lung resection surgery for the management of centrally located lung tumors.

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