Use of Video-Assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications

Stephen M. Cattaneo, Bernard J. Park, Andrew S. Wilton, Venkatraman E. Seshan, Manjit S. Bains, Robert J. Downey, Raja M. Flores, Nabil Rizk, Valerie W. Rusch

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this study was to determine if the utilization of video-assisted thoracic surgery (VATS) for lobectomy for clinical stage I non-small cell lung cancer in elderly patients results in decreased complications compared with lobectomy by thoracotomy (THOR). Methods: A retrospective, matched case-control study was performed evaluating the perioperative outcomes after lobectomy by VATS versus THOR performed in elderly patients (age ≥70 years) at a single institution. All complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0 (http://ctep.cancer.gov/reporting/ctc.html). Results: Between May 1, 2002 and December 31, 2005 333 patients (245 THOR, 88 VATS) 70 years old or greater underwent lobectomy for clinical stage I non-small cell lung cancer. After matching based on age, gender, presence of comorbid conditions, and preoperative clinical stage, there were 82 patients in each group. Patients had similar preoperative characteristics. A VATS approach resulted in a significantly lower rate of complications compared with THOR (28% vs 45%, p = 0.04) and a shorter median length of stay (5 days, range 2 to 20 vs 6 days, range 2 to 27, p < 0.001). No patients undergoing VATS lobectomy had higher than grade 2 complications, whereas 7% of complications in the THOR group were grade 3 or higher. There were no perioperative deaths in the VATS patients compared with an in-hospital mortality rate of 3.6% (3 of 82) for THOR patients. Conclusions: A VATS approach to lobectomy for clinical stage I non-small cell lung cancer in the elderly was associated with fewer and overall reduced severity of complications as well as a shorter hospital stay compared with thoracotomy.

Original languageEnglish (US)
Pages (from-to)231-236
Number of pages6
JournalAnnals of Thoracic Surgery
Volume85
Issue number1
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Cattaneo, S. M., Park, B. J., Wilton, A. S., Seshan, V. E., Bains, M. S., Downey, R. J., Flores, R. M., Rizk, N., & Rusch, V. W. (2008). Use of Video-Assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications. Annals of Thoracic Surgery, 85(1), 231-236. https://doi.org/10.1016/j.athoracsur.2007.07.080