초록접수 현황
| 16F-110 | 구연 발표 |
What is Difficult to do Video-assisted Thoracic Surgery (VATS)? : Comparative Study between VATS Anatomical Resections and Conversion to Thoracotomy for Lung Cancer
Jong-Myeon Hong, Si-Wook Kim, Hong Ju Shin, Do Hun Kim
Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Chungcheongbuk-do, Korea
Background : To investigate causes and clinical outcomes of conversion to thoracotomy during video-assisted thoracoscopic surgery (VATS) anatomical resection
Methods : A total of 245 consecutive pulmonary resections were performed from January 2013 to July 2016 at Chungbuk National University Hospital. The patients who underwent curative and anatomical resection for lung cancer were included in the study. Preoperative basal characteristics, functional factors, radiologic findings and clinical outcomes were compared with converted and non-converted patients.
Results : Of the 245 patients, 91 (benign disease or non-curative surgery) and 17 (non-anatomical resection) were excluded in the study. Of the 137 patients, 51 (37%) who were performed via VATS and 38 (28%) via conversion to thoracotomy were included in the study, but 48 (35%) via planned thoracotomy were excluded. Gender, previous medical history, ASA score, BMI and FEV1 were not different between two groups. However age (p<0.01), enlarged lymph node by CT (p=0.04), lesion of FDG uptake except main mass by PET-CT (P<0.01), and location of the tumor (p=0.03) were significantly different. The age (OR 1.06, p=0.04) and location of the tumor (OR 2.78, p=0.03) were found to predict conversion to thoracotomy by multivariate analysis. Converted patients showed trend of longer duration of thoracic drainage with hospital stay and higher blood loss. The only statistically different factor was operation time (p<0.01).
Conclusion : Elderly patients, in particular their lung mass located in the middle or lower lobe may be likely to have a conversion to thoracotomy during VATS anatomical resection for lung cancer. Especially, these factors can be useful to determine surgical approach of lobectomy for surgeons who are not familiar with VATS.
Methods : A total of 245 consecutive pulmonary resections were performed from January 2013 to July 2016 at Chungbuk National University Hospital. The patients who underwent curative and anatomical resection for lung cancer were included in the study. Preoperative basal characteristics, functional factors, radiologic findings and clinical outcomes were compared with converted and non-converted patients.
Results : Of the 245 patients, 91 (benign disease or non-curative surgery) and 17 (non-anatomical resection) were excluded in the study. Of the 137 patients, 51 (37%) who were performed via VATS and 38 (28%) via conversion to thoracotomy were included in the study, but 48 (35%) via planned thoracotomy were excluded. Gender, previous medical history, ASA score, BMI and FEV1 were not different between two groups. However age (p<0.01), enlarged lymph node by CT (p=0.04), lesion of FDG uptake except main mass by PET-CT (P<0.01), and location of the tumor (p=0.03) were significantly different. The age (OR 1.06, p=0.04) and location of the tumor (OR 2.78, p=0.03) were found to predict conversion to thoracotomy by multivariate analysis. Converted patients showed trend of longer duration of thoracic drainage with hospital stay and higher blood loss. The only statistically different factor was operation time (p<0.01).
Conclusion : Elderly patients, in particular their lung mass located in the middle or lower lobe may be likely to have a conversion to thoracotomy during VATS anatomical resection for lung cancer. Especially, these factors can be useful to determine surgical approach of lobectomy for surgeons who are not familiar with VATS.
책임저자: Do Hun Kim
Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Chungcheongbuk-do, Korea
발표자: Do Hun Kim, E-mail : mwille@naver.com