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Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach.

Publication ,  Journal Article
Atkins, BZ; Harpole, DH; Mangum, JH; Toloza, EM; D'Amico, TA; Burfeind, WR
Published in: Ann Thorac Surg
October 2007

BACKGROUND: Previous studies have discouraged limited pulmonary resection for primary lung cancer, but pulmonary segmentectomy has advantages for some patients. Furthermore, while thoracoscopic lobectomy has been increasingly applied with well-demonstrated advantages compared with thoracotomy, few data exist regarding thoracoscopic approaches to pulmonary segmentectomy. This study compares thoracoscopic segmentectomy (TS) with open segmentectomy (OS). METHODS: This is a retrospective review of prospectively collected data for 77 consecutive segmentectomy patients treated between 2000 and 2006 at a single center. Preoperative, intraoperative, and postoperative variables for patients undergoing TS (n = 48) were compared with those undergoing OS (n = 29). Student's t tests were used for continuous data and Fisher's exact tests for dichotomous data. RESULTS: Baseline demographics were similar between groups. Indications for pulmonary resection included non-small cell lung cancer (n = 39), metastatic disease (n = 30), and other diagnoses (n = 8). All common segmentectomies were represented. No thoracoscopic cases required conversion to open procedures. Operative times, estimated blood loss, and chest tube duration were similar between groups. Outcomes were similar except that hospital length of stay was significantly less among TS patients (length of stay 6.8 +/- 6 days OS versus 4.3 +/- 3 days TS; p = 0.03). Thirty-day mortality was 6.9% (2 of 29) for the OS group compared with 0% for the TS group. Long-term survival rates were significantly better in the TS group (p = 0.0007). CONCLUSIONS: Thoracoscopic segmentectomy is a safe and feasible procedure, comparing favorably with OS by reducing hospital length of stay. For experienced thoracoscopic surgeons, TS appears to be a sound option for lung-sparing, anatomic pulmonary resections.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

October 2007

Volume

84

Issue

4

Start / End Page

1107 / 1112

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Thoracotomy
  • Thoracoscopy
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Probability
  • Pneumonectomy
  • Pain, Postoperative
  • Neoplasm Recurrence, Local
 

Citation

APA
Chicago
ICMJE
MLA
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Atkins, B. Z., Harpole, D. H., Mangum, J. H., Toloza, E. M., D’Amico, T. A., & Burfeind, W. R. (2007). Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach. Ann Thorac Surg, 84(4), 1107–1112. https://doi.org/10.1016/j.athoracsur.2007.05.013
Atkins, B Zane, David H. Harpole, Jennifer H. Mangum, Eric M. Toloza, Thomas A. D’Amico, and William R. Burfeind. “Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach.Ann Thorac Surg 84, no. 4 (October 2007): 1107–12. https://doi.org/10.1016/j.athoracsur.2007.05.013.
Atkins BZ, Harpole DH, Mangum JH, Toloza EM, D’Amico TA, Burfeind WR. Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach. Ann Thorac Surg. 2007 Oct;84(4):1107–12.
Atkins, B. Zane, et al. “Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach.Ann Thorac Surg, vol. 84, no. 4, Oct. 2007, pp. 1107–12. Pubmed, doi:10.1016/j.athoracsur.2007.05.013.
Atkins BZ, Harpole DH, Mangum JH, Toloza EM, D’Amico TA, Burfeind WR. Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach. Ann Thorac Surg. 2007 Oct;84(4):1107–1112.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

October 2007

Volume

84

Issue

4

Start / End Page

1107 / 1112

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Thoracotomy
  • Thoracoscopy
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Probability
  • Pneumonectomy
  • Pain, Postoperative
  • Neoplasm Recurrence, Local