Adopting a standardized anterior approach significantly increases video-assisted thoracoscopic surgery lobectomy rates

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Philip McElnayDouglas West

Abstract

Video-assisted thoracoscopic surgery (VATS) lobectomy is associated with improved short-term outcomes compared with thoracotomy. Definition of the hilar structures is crucial to safe VATS lobectomy. Several VATS approaches have been described. We report the effect of three surgeons in our institution undertaking standardized anterior approach (SAA) training on the proportion of isolated lobectomies subsequently completed by VATS. Predictors of successful VATS lobectomy were analysed. Three consultant surgeons undertook SAA training at two different time points. Two were performing VATS lobectomy prior to SAA training. Training involved a 2-day visit to an established SAA unit. Lobectomies performed by these surgeons between April 2011 and December 2012 (20 months), before and after training, were recorded prospectively. Bilobectomies, sleeve resections, pneumonectomies and chest wall resections were excluded. VATS lobectomy proportions before and after training were compared. Independent predictors of completion by VATS rather than thoracotomy were identified by multivariable logistic regression. One hundred and sixty-three isolated lobectomies were performed, 97 of these by VATS (59.5%). The mean age was 68.8 (± 10.5) years. P...Continue Reading

References

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Citations

Feb 8, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Gaetano Rocco
Oct 31, 2015·Scandinavian Cardiovascular Journal : SCJ·Bo Laksáfoss HolbekHenrik Jessen Hansen
Sep 2, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hisashi IwataHiroyasu Komuro
Feb 26, 2016·General Thoracic and Cardiovascular Surgery·Bo Laksáfoss HolbekHenrik Jessen Hansen
Aug 26, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Philip J McElnayGianluca Casali
Mar 8, 2017·The Annals of Thoracic Surgery·Mark K Ferguson, Cathy Bennett
Oct 20, 2017·Annals of the Royal College of Surgeons of England·P TcherveniakovN Chaudhuri
Nov 1, 2020·The Annals of Thoracic Surgery·Darren S BryanNirmal K Veeramachaneni
Jul 29, 2021·JTCVS Techniques·Ramiro Fernandez, Usman Ahmad

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