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 2008
Externally publishedYes

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Video-Assisted Thoracic Surgery
Thoracotomy
Non-Small Cell Lung Carcinoma
Length of Stay
National Cancer Institute (U.S.)
Hospital Mortality
Terminology
Case-Control Studies
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Use of Video-Assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications. / Cattaneo, Stephen M; Park, Bernard J.; Wilton, Andrew S.; Seshan, Venkatraman E.; Bains, Manjit S.; Downey, Robert J.; Flores, Raja M.; Rizk, Nabil; Rusch, Valerie W.

In: Annals of Thoracic Surgery, Vol. 85, No. 1, 01.2008, p. 231-236.

Research output: Contribution to journalArticle

Cattaneo, SM, Park, BJ, Wilton, AS, Seshan, VE, Bains, MS, Downey, RJ, Flores, RM, Rizk, N & Rusch, VW 2008, 'Use of Video-Assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications', Annals of Thoracic Surgery, vol. 85, no. 1, pp. 231-236. https://doi.org/10.1016/j.athoracsur.2007.07.080
Cattaneo, Stephen M ; Park, Bernard J. ; Wilton, Andrew S. ; Seshan, Venkatraman E. ; Bains, Manjit S. ; Downey, Robert J. ; Flores, Raja M. ; Rizk, Nabil ; Rusch, Valerie W. / Use of Video-Assisted Thoracic Surgery for Lobectomy in the Elderly Results in Fewer Complications. In: Annals of Thoracic Surgery. 2008 ; Vol. 85, No. 1. pp. 231-236.
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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.",
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AU - Park, Bernard J.

AU - Wilton, Andrew S.

AU - Seshan, Venkatraman E.

AU - Bains, Manjit S.

AU - Downey, Robert J.

AU - Flores, Raja M.

AU - Rizk, Nabil

AU - Rusch, Valerie W.

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N2 - 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.

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