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

Authors:
Celal Bugra Sezen
Celal Bugra Sezen
Gazi University Medical School
Salih Bilen
Salih Bilen
Yedikule Chest Diseases and Surgery Training and Research Hospital
Cem Emrah Kalafat
Cem Emrah Kalafat
Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Levent Cansever
Levent Cansever
Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery
Turkey
Yasar Sonmezoglu
Yasar Sonmezoglu
Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery
Turkey

Gen Thorac Cardiovasc Surg 2019 Apr 19. Epub 2019 Apr 19.

Department of Thoracic Surgery, Istinye University Medical Faculty, Liv Hospital Ulus, Istanbul, Turkey.

Background: The aim of this study was to discuss indications and outcomes for conversion to thoracotomy during thoracoscopic lobectomy.

Materials And Methods: Patients who underwent lobectomy for non-small cell lung cancer between January 2012 and December 2016 were evaluated retrospectively. The study included 129 patients who underwent video-assisted thoracoscopic lobectomy (group-V) and 18 patients converted from thoracoscopic lobectomy to thoracotomy due to unexpected intraoperative complications (group-T).

Results: The two patient groups showed no statistical differences in terms of demographic characteristics. Causes of unexpected conversions to thoracotomy were hemorrhage in six patients, dense pleural adhesions in seven patients, fused fissure in one patient, and fibrocalcified lymph nodes around the vascular structures in four patients. Operative time was 180.37 ± 68.6 min in group-V and 235 ± 72.6 min in group-T (p = 0.003). Intraoperative blood loss was 263.9 ± 180.6 mL in group-V, compared to 562.7 ± 296.2 mL in group-T (p < 0.001). Patient age ≥ 70 years was a significant risk factor for conversion to thoracotomy (p = 0.015, odds ratio 4.73). The 5-year survival rate in group-V was 71.4% {mean: 65.2 months [95% confidence interval (CI) 59.6-70.8]}, while that in group-T was 80% [mean 54.9 months (95% CI 45.9-63.8)] (p = 0.548).

Conclusion: Advanced age was identified as the main risk factor for conversion to thoracotomy. However, early- and long-term outcomes were similar in the two groups, indicating that video-assisted thoracoscopic surgery is a safe and applicable method.

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Source
http://link.springer.com/10.1007/s11748-019-01127-1
Publisher Site
http://dx.doi.org/10.1007/s11748-019-01127-1DOI Listing
April 2019
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References

(Supplied by CrossRef)
Article in Ann Thorac Surg
RJ McKenna Jr et al.
Ann Thorac Surg 2006
Article in Semin Thorac Cardiovasc Surg
WS Walker et al.
Semin Thorac Cardiovasc Surg 1998
Article in Surg Today
H Nomori et al.
Surg Today 2003
Article in Thorac Surg Clin
WS Walker et al.
Thorac Surg Clin 2007
Article in Ann Thorac Surg
CE Nwogu et al.
Ann Thorac Surg 2015
Article in Ann Thorac Surg
BA Whitson et al.
Ann Thorac Surg 2008
Article in BMJ
CR Larsen et al.
BMJ 2009
Article in J Thorac Cardiovasc Surg
MF Reed et al.
J Thorac Cardiovasc Surg 2008
Article in Kyobu Geka
K Sugi et al.
Kyobu Geka 2003
Article in Interact Cardiovasc Thorac Surg
R Nakanishi et al.
Interact Cardiovasc Thorac Surg 2008
Article in Chest
FC Detterbeck et al.
Chest 2017

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