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Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience

  
@article{JTD22937,
	author = {Benoît Bédat and Etienne Abdelnour-Berchtold and Thorsten Krueger and Jean Yannis Perentes and Hans-Beat Ris and Frédéric Triponez and Marc-Joseph Licker and Wolfram Karenovics and Michel Gonzalez},
	title = {Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience},
	journal = {Journal of Thoracic Disease},
	volume = {10},
	number = {8},
	year = {2018},
	keywords = {},
	abstract = {Background: Pulmonary anatomical segmentectomies are increasingly being done via video-assisted thoracoscopic surgery (VATS). We analyzed clinical outcomes and risk factors for post-operative complications after pulmonary segmentectomy by VATS was introduced in two institutions. 
Methods: We retrospectively reviewed records of all patients who underwent anatomical pulmonary segmentectomy by VATS from 2014 to 2016 at the university hospitals of Geneva and Lausanne in Switzerland. 
Results: One hundred twenty-nine patients (64 men; median age 68 years, range, 29–85 years) underwent anatomical VATS segmentectomy for primary lung tumors (n=100), metastases (n=16) and benign lesions (n=13). The overall 30-day mortality and morbidity rates were 0.8% and 31%, respectively. The reoperation rate was 4.7% [indications: hemothorax 2, prolonged air leak (PAL) 2, segmental torsion 1, empyema 1]. Chest drainage lasted for a median of 2 days (range, 1–33 days) and patients were discharged from the hospital after a median of 6 days (range, 2–37 days). Postoperative complications were mainly associated with chronic obstructive pulmonary disease (COPD) [odds ratio (OR) 2.54 and 95% confidence interval (95% CI), 1.18–5.47], and smoking pack-years >50 units (OR 5.27; 95% CI, 1.68–16.55). Nine patients (9%) presented with distant recurrences. Nodule size >2 cm was associated with decreased disease-free survival (DFS) (P=0.04). There was no association between surgical experience in VATS segmentectomy and DFS or postoperative complications. 
Conclusions: Segmentectomies can be safely performed by VATS in an initial experience and result in favorable clinical outcome. COPD and smoking pack-years are associated with an increased risk of complications.},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/22937}
}