Korean J Thorac Cardiovasc Surg.  2017 Aug;50(4):275-280. 10.5090/kjtcs.2017.50.4.275.

No Adverse Outcomes of Video-Assisted Thoracoscopic Surgery Resection of cT2 Non-Small Cell Lung Cancer during the Learning Curve Period

• Bilgi Z
• Batırel H
• Yıldızeli B
• Bostancı
• Laçin T
• Yüksel M

• KMID: 2387914
• DOI: http://doi.org/10.5090/kjtcs.2017.50.4.275

Abstract

BACKGROUND
Video-assisted thoracoscopic surgery (VATS) anatomic lung resections are gradually becoming the standard surgical approach in early-stage non-small cell lung cancer (NSCLC). The technique is being applied in cases of larger tumors depending on the experience of the surgical team. The objective of this study was to compare early surgical and survival outcomes in patients undergoing anatomic pulmonary resections using VATS and thoracotomy techniques for clinical T2 NSCLC during the adaptation period of the surgical team to the VATS approach.
METHODS
The data of all patients who underwent anatomic pulmonary resection for NSCLC using VATS and open techniques since April 2012 were recorded to create a prospective lung cancer database. Clinical T2 NSCLC patients who underwent VATS anatomic lung resection were identified and compared with cT2 patients who underwent open resection.
RESULTS
Between April 2012 and August 2014, 269 anatomical resections for NSCLC were performed (80 VATS and 189 thoracotomy). Thirty-four VATS patients who had clinical T2 disease were identified and stage-matched to thoracotomy patients. The average tumor diameter was comparable (34.2±11.1×29.8±10.1 mm vs. 32.3±9.8×32.5±12.2 mm, p=0.4). Major complications were higher in the thoracotomy group (n=0 vs. n=5, p=0.053). There was no 30-day mortality, and the 2-year survival rate was 91% for VATS and 82% for thoracotomy patients (p=0.4).
CONCLUSION
VATS anatomic resections in clinical T2 NSCLC tumors are safe and have perioperative and pathologic outcomes similar to those of thoracotomy, while remaining within the learning curve.

Keyword

Video-assisted thoracic surgery; Surgical complications; Learning curve; Patient safety

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Humans
Learning Curve*
Learning*
Lung
Lung Neoplasms
Mortality
Patient Safety
Prospective Studies
Survival Rate
Thoracic Surgery, Video-Assisted*
Thoracotomy