Unexpected conversion to thoracotomy during thoracoscopic lobectomy: a single-center analysis

Sezen, Celal Buğra; Bilen, Salih; Kalafat, Cem Emrah; Cansever, Levent; Sönmezoğlu, Yaşar; Kilimci, Umut; Doğru, Mustafa Vedat; Seyrek, Yunus; Kocatürk, Celalettin

doi:10.1007/s11748-019-01127-1

Cited by 16 publications

(31 citation statements)

References 20 publications

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“…However, studies of the same type put forward different points of view. A single-center study concluded that there was no signi cant difference in survival and recurrence between groups with successful VATS and conversion to thoracotomy, but the operation time and hospital stay were longer in the group with conversion to thoracotomy [14]. Another retrospective study also showed that unplanned thoracotomy did not affect the prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to nutritional status, age and CCI may also be predictors of PCCs. Some studies found that elderly patients were more likely to have PCCs [14,15], but a prospective American research suggested that age could not predict the occurrence of major postoperative complications [16], and one patient's physique-related indexes could better predict the occurrence of PCCs. The Charlson Comorbidity Index (CCI) is also a good indicator for evaluating postoperative complications [15,17], and CCI has many overlaps with the criteria for assessing frailty, so both can re ect frailty.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors of Complications After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer-A Retrospective Study

Wang

Xia

Yin

et al. 2021

Preprint

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Background: Video-assisted thoracoscopic surgery, safe and minimally invasive, is the first strategy recommended for non-small cell lung cancer. The purpose of this study was to determine the risk factors for postoperative cardiopulmonary complications (including cardiac and pulmonary complications) in patients with NSCLC who underwent video-assisted thoracoscopic surgery (VATS).Methods: We retrospectively collected information of 3142 lung cancer patients undergoing VATS tumor resection at Jiangsu Provincial People's Hospital from January 2017 to June 2018, and established a clinical prediction model using the factors selected by univariate analysis.Results: A total of 305 in 3142 patients developed postoperative cardiopulmonary complications. In univariate analysis, age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, albumin before surgery, pre-albumin, Δalbumin and pleura adhesion were all associated with cardiac and pulmonary complications. Multivariate analysis showed that age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, pre-albumin, Δalbumin were important independent risk factors for complications. Finally, age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, Δalbumin variables were included in the model (AUC=0.743).Conclusion: Nutritional status (PNI, pre-albumin), CCI, age, long-term smoking history before surgery, conversion to thoracotomy were all independent risk factors for postoperative complications and poor prognosis. Experienced surgeons should instruct the operation of high-risk patients to avoid long-term hospitalization and possible poor prognosis after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Factors of Complications After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer-A Retrospective Study

Wang

Xia

Yin

et al. 2021

Preprint

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“…In addition, prior literature comparing outcomes between those undergoing successfully completed MIS and those undergoing a conversion to thoracotomy shows inconsistencies. Some authors report comparable outcomes between the 2 groups, 6,7 while others suggest increased perioperative mortality due to aspiration, pneumonia, and pulmonary embolism in the group undergoing conversion. 5,8 The National Cancer Database (NCDB) is the largest cancer registry in the world that currently captures 72% of all newly diagnosed malignancies annually in the United States from more than 1,500 Commission on Cancer-approved facilities.…”

Section: Central Messagementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Conversion to Thoracotomy in Non-Small Cell Lung Cancer: Risk Factors and Perioperative Outcomes

Muslim

Stroever²,

Poulikidis

et al. 2022

Innovations�(Phila)

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Objective: We aimed to identify predictors of conversion to thoracotomy and test the hypothesis that conversion is associated with inferior perioperative outcomes in non-small cell lung cancer (NSCLC). Methods: We queried the National Cancer Database for patients with stage I to III NSCLC undergoing minimally invasive surgery (MIS) during 2010 to 2016. We compared clinicopathologic factors between patients undergoing MIS with and without conversion. We fitted multivariable regression models to identify independent predictors of conversion and compare perioperative outcomes between the 2 groups. Results: A rising trend in the use of MIS was accompanied by a declining trend in the rate of conversion to thoracotomy. A total of 11.3% of the 83,219 cases were converted. Conversion was associated with a higher Charlson-Deyo score, squamous histology, nodal involvement, high tumor grade, tumor size ≥5 cm, and a higher T stage ( P < 0.05). Successful MIS without conversion was predicted by advanced age, sublobar resection, robotic approach, and treatment at an academic high-volume facility ( P < 0.05). Conversion was linked to longer hospital stays, higher 30-day and 90-day mortality, and unplanned readmission ( P < 0.05), irrespective of the type of MIS approach. Conclusions: Conversion rates for video-assisted and robot-assisted thoracoscopic surgery have seen a decline in recent years. Irrespective of the type of MIS approach, conversion was associated with inferior perioperative outcomes. The robotic approach and treatment at an academic high-volume facility were associated with a lower likelihood of conversion. Early recognition of the individual risk factors for conversion may help to counsel patients about the likelihood of, and detriments associated with, conversion and ultimately reduce conversion rates.

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“…The most important advantages of minimally invasive surgery are better cosmetic results, less pain, earlier mobilization, less drainage time, less postoperative hospital stay and less moribidity than thoracotomy [11,12]. It is considered that the most important reason of less acute and chronic pain is the absence of costal exclusion.…”

Section: Vats Lung Resectionsmentioning

confidence: 99%

Video-assisted thoracic surgery in advanced non-small cell lung cancer treatment

Gökçe¹,

Sezen²

2020

Arch Surg Clin Res

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Non-small cell lung cancer is one of the leading causes of cancer-related mortality worldwide. Despite recent advances in adjuvant treatments, surgical resection is basis of treatment. With the development of minimally invasive surgery in thoracic surgery, surgeons work on minimally invasive surgery for advanced stages of lung cancer, previously considered non-operable at all or previously considered non-operable with minimally invasive surgery approach. Minimally invasive surgical techniques which are routinely used in the surgical treatment of early-stage lung cancer have started to be treated in more complicated and advanced stages of lung cancer. Bilateral anatomic resections, operations after neoadjuvant chemotherapy, bronchial sleeve lobectomies, double sleeve lobectomies, complementary pneumonectomies, and carinal sleeve resections can be performed by minimally invasive methods. The option of video-assisted surgery should be considered with oncological principles at foreground if patients have acceptable lung and cardiac performance conditions with minimal comorbidities. This study reviews VATS experience in patients with advanced-stage lung cancer worldwide and discusses potential benefi ts and limitations of using VATS technology to perform thoracic surgery procedures.

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Unexpected conversion to thoracotomy during thoracoscopic lobectomy: a single-center analysis

Cited by 16 publications

References 20 publications

Prognostic Factors of Complications After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer-A Retrospective Study

Prognostic Factors of Complications After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer-A Retrospective Study

Conversion to Thoracotomy in Non-Small Cell Lung Cancer: Risk Factors and Perioperative Outcomes

Video-assisted thoracic surgery in advanced non-small cell lung cancer treatment

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