TY  - JOUR
AU  - Velez-Cubian, Frank O.
AU  - Zhang, Wei-Wei
AU  - Rodriguez, Kathryn L.
AU  - Thau, Matthew R.
AU  - Ng, Emily P.
AU  - Moodie, Carla C.
AU  - Garrett, Joseph R.
AU  - Fontaine, Jacques-Pierre
AU  - Toloza, Eric M.
PY  - 2016
TI  - Effect of small body habitus on peri-operative outcomes after robotic-assisted pulmonary lobectomy: retrospective analysis of 208 consecutive cases
JF  - Journal of Thoracic Disease; Vol 8, No 6 (June 01, 2016): Journal of Thoracic Disease
Y2  - 2016
KW  - 
N2  - Background: Patients with smaller body surface area (BSA) have smaller pleural cavities, which limit visualization and instrument mobility during video-assisted thoracoscopic surgery (VATS). We investigated the effects of BSA on outcomes with robotic-assisted VATS lobectomy.  Methods: We analyzed 208 consecutive patients who underwent robotic-assisted lobectomy over   34 months. Patients were separated into group A (BSA ≤1.65 m2) and group B (BSA >1.65 m2). Operative times, estimated blood loss (EBL), conversions to thoracotomy, complications, hospital length of stay (LOS), and in-hospital mortality were compared.   Results: Group A had 40 patients (BSA 1.25–1.65 m2), and group B had 168 patients (BSA 1.66–2.86 m2). Median skin-to-skin operative times [± standard error of the mean (SEM)] were 169±16 min for group A and 176±6 min for group B (P=0.34). Group A had median EBL of 150±96 mL compared to 200±24 mL for group B (P=0.37). Overall conversion rate to thoracotomy was 8/40 (20.0%) in group A versus 12/168 (7.1%) in group B (P=0.03); while emergent conversion for bleeding was 2/40 (5.0%) in group A versus 5/168 (3.0%) in group B (P=0.62). Postoperative complications occurred in 12/40 (30.0%) in group A, compared to 66/168 (39.3%) in group B (P=0.28). Patients from both groups had median hospital LOS of 5 days (P=0.68) and had similar in-hospital mortality.  Conclusions: Patients with BSA ≤1.65 m2 have similar perioperative outcomes and complication risks as patients with larger BSA. Patients with BSA ≤1.65 m2 have a higher overall conversion rate to thoracotomy, but similar conversion rate for bleeding as patients with larger BSA. Robotic-assisted pulmonary lobectomy is feasible and safe in patients with small body habitus.
UR  - https://jtd.amegroups.org/article/view/7672