Thoracoscopic Lobectomy Has Increasing Benefit in Patients With Poor Pulmonary Function

• DOI: 10.1097/sla.0b013e318265819c
• Publication Date: 2012-08-07T07:43:38Z
• Authors: DuyKhanh P. Ceppa; Andrzej S. Kosinski; Mark F. Berry; Betty C. Tong; David H. Harpole; John D. Mitchell; Thomas A. D'Amico; Mark W. Onaitis
• Keywords: Thoracotomy; DLCO; VATS lobectomy; Cardiothoracic surgery

In Brief Objective: Using a national database, we asked whether video-assisted thoracoscopic surgery (VATS) lobectomy is beneficial in high-risk pulmonary patients. Background: Single-institution series demonstrated benefit of VATS over via thoracotomy poor function patients [FEV1 (forced expiratory volume 1 second) or DLCO (diffusion capacity the lung to carbon monoxide) <60% predicted]. Methods: The STS General Thoracic Database was queried for having undergone by either between 2000 and 2010. Postoperative complications included those defined database. Results: 12,970 underwent (thoracotomy, n = 8439; VATS, 4531) met inclusion criteria. overall rate 21.7% (1832/8439) 17.8% (806/4531) undergoing with respectively (P < 0.0001). multivariable model complications, approach (OR 1.25, P 0.001), decreasing FEV1% predicted 1.01 per unit, 0.001) DLCO% increasing age (1.02 year, independently complications. When examining FEV1 less than 60% predicted, have markedly increased when compared 0.023). No significant difference noted more predicted. Conclusions: Poor predicts respiratory regardless approach. Respiratory increase at significantly greater after VATS. Planned surgical should be considered while determining patient an appropriate resection candidate. Database, examined experienced decreased morbidity thoracotomy.