Unplanned readmission and survival after video-assisted thoracic surgery and open thoracotomy in patients with non-small-cell lung cancer: a 12-month nationwide cohort study

Bouabdallah, Ilies; Pauly, Vanessa; Viprey, Marie; Orléans, Veronica; Fond, Guillaume; Auquier, Pascal; D’Journo, Xavier Benoît; Boyer, Laurent; Thomas, Philippe

doi:10.1093/ejcts/ezaa421

Cited by 14 publications

(6 citation statements)

References 26 publications

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“…The quality and completeness of the coding are evaluated locally by the medical information departments of the individual institutions and nationally by the national health insurance system. Due to the reliability and quality of this database we have been able to use this database in several papers published in international journals of high rank on several topics [ 25 , 41 ], in particular on the same subject [ 6 , 7 , 42 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the SARS-CoV-2 Epidemic on Lung Cancer Surgery in France: A Nationwide Study

Pagès

Cottenet

Bonniaud

et al. 2021

Cancers

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Few studies have investigated the link between SARS-CoV-2 and health restrictions and its effects on the health of lung cancer (LC) patients. The aim of this study was to assess the impact of the SARS-CoV-2 epidemic on surgical activity volume, postoperative complications and in-hospital mortality (IHM) for LC resections in France. All data for adult patients who underwent pulmonary resection for LC in France in 2020, collected from the national administrative database, were compared to 2018–2019. The effect of SARS-CoV-2 on the risk of IHM and severe complications within 30 days among LC surgery patients was examined using a logistic regression analysis adjusted for age, sex, comorbidities and type of resection. There was a slight decrease in the volume of LC resections in 2020 (n = 11,634), as compared to 2018 (n = 12,153) and 2019 (n = 12,227), with a noticeable decrease in April 2020 (the peak of the first wave of epidemic in France). We found that SARS-CoV-2 (0.43% of 2020 resections) was associated with IHM and severe complications, with, respectively, a sevenfold (aOR = 7.17 (3.30–15.55)) and almost a fivefold (aOR = 4.76 (2.31–9.80)) increase in risk. Our study suggests that LC surgery is feasible even during a pandemic, provided that general guidance protocols edited by the surgical societies are respected.

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Section: Discussionmentioning

confidence: 99%

Impact of the SARS-CoV-2 Epidemic on Lung Cancer Surgery in France: A Nationwide Study

Pagès

Cottenet

Bonniaud

et al. 2021

Cancers

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“…While this method of pain control has clear benefit in terms of cost savings, it also has potential implications for long-term survival. Several studies have shown higher long-term mortality rates among pulmonary resection patients who develop pneumonia post-operatively (17)(18)(19)(20)(21). Given the association between post-operative pain and development of pneumonia, this improved post-operative pain control suggests a potential survival advantage for pulmonary resection patients receiving LB-based INB (1).…”

Section: Discussionmentioning

confidence: 98%

Intercostal nerve blockade with liposomal bupivacaine reduces length of stay after video assisted thoracic surgery (VATS) lobectomy

Banks¹,

Ely²,

Hsu³

et al. 2022

J Thorac Dis

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Background: Intercostal nerve blockade (INB) for thoracic surgery analgesia has gained popularity in practice, but evidence demonstrating its efficacy remains sparse and inconsistent. We investigated the effect of INB with standard bupivacaine (SB) with epinephrine versus liposomal bupivacaine (LB) versus a mixed solution of the two on postoperative pain control and outcomes in video assisted thoracoscopic lobectomy patients.Methods: Since 2014, our practice has shifted from using INBs with SB with epinephrine, to LB, to a mix of the two as the central component of multimodal analgesia after video assisted thoracoscopic surgery. The blocks are performed in a standardized fashion under thoracoscopic visualization consecutively from two rib spaces above to two below the outermost incisions. We retrospectively compared all minimally invasive lobectomies performed at our institution between January 2014 and July 2018 by type of local anesthetic used for INB. We examined median length of stay (LOS), opioid utilization, and subjective pain scores [0-10].Results: Out of 302 minimally invasive lobectomy patients, 34 received SB with epinephrine, 222 received LB alone, and 46 received the mixed solution. LOS was almost a full day shorter in the LB group than in the SB group (34.8 vs. 56.5 hours, P=0.01). There was nearly 25% lower median total morphine equivalent utilization in the mixed solution cohort compared to the LB cohort (−7.1 mg, P=0.02). Additionally, IV morphine equivalent utilization was over 50% lower in the mixed solution group than in the SB with epinephrine group (−10.0 mg, P=0.03).Conclusions: Our study is by far the largest (N=302) to compare types of local anesthetic used for INB within a uniform case population. The reductions in LOS and opiate utilization observed in our study among patients receiving LB-based formulations were both statistically and clinically significant.

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“…Their findings showed that pulmonary complications were comparable between VATS and thoracotomy groups (32.2% vs. 31.2%; p=0.55). Similarly, in a nationwide propensity-matched cohort study involving 13,027 patients, it was found that VATS did not demonstrate a significant reduction in the risk of unplanned readmission compared to open thoracotomy (20.7% vs. 21.9%, hazard ratio=1.03) [ 21 ]. Most of the resources indicated that most frequent complications associated with readmission at 30 days, 90 days, and 12 months were pulmonary complications without difference between VATS and open thoracotomy (10.9% vs 11.1% at 12 months, p=0.2510) [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Pulmonary Complications in Patients Undergoing Elective Thoracotomy Versus Thoracoscopic Surgeries

Al-Githmi,

Alotaibi,

Habeebullah

et al. 2023

Cureus

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Background Postoperative pulmonary complications correlate highly with thoracic surgery compared to other surgeries. Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical approach that provides considerable advantages over major open thoracotomy. Methodology This is a retrospective cohort study. All patients aged 18 years and above of both genders were included in the study. Cases following up outside King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, were excluded from our study. Complications were measured per the records on follow-up day 1, day 7, and day 30. Mortality was measured within 30 days after the surgery. Results A total of 151 patients were included in the study. Age ranged from 18 to 85 years, with males representing 62.3% of the sample, while Saudis represented 59.6%. VATS was performed in 71.5%, while thoracotomy was performed in 28.5%. Of the total, 19.4% had postoperative complications within 30 days in the VATS group, while 23.3% were in the thoracotomy group. No significant differences were found between the rates of complications between the two groups. Additionally, the admission rate to ICU was significantly twice as common in the thoracotomy group (65.1%) compared to the VATS group (33.3%). Besides, the average duration of the chest tube's stay was three to seven days in both groups (62.1% in the VATS group and 70.7% in the thoracotomy group). Lastly, regarding the requirements of opioids, VATS showed more need for opioids (44.4%) compared to thoracotomy (32.6%). Conclusion The rates of postoperative complications were low in both groups, and no significant differences were found between the two procedures. In addition, the VATS group showed significantly higher use of opioids compared to the thoracotomy group. We recommend conducting further studies with larger sample sizes to increase the statistical power of detection.

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Unplanned readmission and survival after video-assisted thoracic surgery and open thoracotomy in patients with non-small-cell lung cancer: a 12-month nationwide cohort study

Cited by 14 publications

References 26 publications

Impact of the SARS-CoV-2 Epidemic on Lung Cancer Surgery in France: A Nationwide Study

Impact of the SARS-CoV-2 Epidemic on Lung Cancer Surgery in France: A Nationwide Study

Intercostal nerve blockade with liposomal bupivacaine reduces length of stay after video assisted thoracic surgery (VATS) lobectomy

Postoperative Pulmonary Complications in Patients Undergoing Elective Thoracotomy Versus Thoracoscopic Surgeries

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