초록접수 현황
| 20F-188 | 구연 발표 |
Early outcomes of VATS advanced resection: Pneumonectomy and sleeve lobectomy
Soyoung Lee, Jae Hyun Jeon, Beatrice Chia-Hui Shih, Wan Jin Hwang, Woohyun Jung, Yoohwa Hwang, Sukki Cho, Kwhanmien Kim, Sanghoon Jheon
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University Hospital College of Medicine, Seoul, Republic of Korea
Purpose : This study is to examine the recent trends in surgical approach related to advanced resection in our hospital, and to compare the early outcomes of video-assisted thoracic surgery (VATS) approach and open procedure in advanced resections (sleeve lobectomy, and pneumonectomy).
Methods : The study patients were divided into two groups: patients undergoing VATS advanced resection (n=47) and patients undergoing open advanced resection (n=63). A propensity analysis that incorporated preoperative variables, such as age, sex, preoperative pulmonary function, prior chemotherapy, extent of operation, pathologic T staging, pathologic N staging, was performed, and early postoperative outcomes were compared.
Results : Matching based on propensity scores produced 33 patients in each group for the analysis of early postoperative outcomes. VATS advanced resection was similar oncologic outcomes such as the number of dissected lymph nodes, R0 resection, nodal upstaging compared with thoracotomy. The operation time was similar, and the hospital stay was short in VATS, but there was no significant difference (7 vs. 9, p=0.456). There were three operative mortalities in the thoracotomy group, and these patients died of postoperative pneumonia or pulmonary embolism. The overall incidence of postoperative complications was 51.5% (17 of 33) and 27.3% (9 of 33) in the thoracotomy group and the VATS group, respectively (p=0.039).
Conclusion : In select patients, superior short-term surgical result and equal oncological outcomes (R0 resection, number of dissected LNs, and nodal upstaging ratio) were achieved with VATS approach compared with open procedure. If technically feasible, VATS advanced resection might improve the early outcomes in selected lung cancer patients.
Methods : The study patients were divided into two groups: patients undergoing VATS advanced resection (n=47) and patients undergoing open advanced resection (n=63). A propensity analysis that incorporated preoperative variables, such as age, sex, preoperative pulmonary function, prior chemotherapy, extent of operation, pathologic T staging, pathologic N staging, was performed, and early postoperative outcomes were compared.
Results : Matching based on propensity scores produced 33 patients in each group for the analysis of early postoperative outcomes. VATS advanced resection was similar oncologic outcomes such as the number of dissected lymph nodes, R0 resection, nodal upstaging compared with thoracotomy. The operation time was similar, and the hospital stay was short in VATS, but there was no significant difference (7 vs. 9, p=0.456). There were three operative mortalities in the thoracotomy group, and these patients died of postoperative pneumonia or pulmonary embolism. The overall incidence of postoperative complications was 51.5% (17 of 33) and 27.3% (9 of 33) in the thoracotomy group and the VATS group, respectively (p=0.039).
Conclusion : In select patients, superior short-term surgical result and equal oncological outcomes (R0 resection, number of dissected LNs, and nodal upstaging ratio) were achieved with VATS approach compared with open procedure. If technically feasible, VATS advanced resection might improve the early outcomes in selected lung cancer patients.
첨부파일 : VATS Advanced Resection.pptx
책임저자: Kwhanmien Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University Hospital College of Medicine, Seoul, Republic of Korea
발표자: Soyoung Lee, E-mail : faustina117@gmail.com