An evaluation of lymph node harvest in sublobar resections in a statewide quality collaborative.

IF 4.9 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-02-27 DOI:10.1016/j.jtcvs.2025.02.016

Jenny Bui, Stanley Kalata, Rishindra M Reddy, Melissa Clark, Mary Hollenbeck, Nathan Mollberg, Shelly Lall, Andrew M Popoff

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引用次数: 0

Abstract

Objective: Evaluate the effectiveness of nodal harvest in sublobar resections for peripheral non-small cell lung cancer.

Methods: Retrospective review of prospectively collected data for patients who underwent wedge resection (WR) and segmentectomy (SG) for non-small cell lung cancer from January 2015 to March 2023 at 21 centers within a statewide quality collaborative. The primary end point was the extent of lymph node (LN) harvest defined as ≥10 LNs, ≥5 LN stations (LNSs), or 3 mediastinal LNSs and 1 hilar LNS (3/1 LNS). We also examined the LN harvest stratified by operative approach (open, video-assisted, or robot-assisted).

Results: A total of 1398 patients receiving sublobar resections were reviewed: 919 (65.7%) with WR and 479 (34.3%) with SG. Only 15.6% (152) WR and 54.6% (263) SG had an adequate number of LNSs harvested. Robot-assisted thoracic surgery was associated with higher rates of harvesting ≥10 LNs (P < .001) or harvesting ≥5 LNSs or 3/1 LNS (P < .001) compared with video-assisted thoracoscopic surgery for WR. Compared with open procedures and video-assisted thoracic surgery, Robot-assisted thoracic surgery was associated with higher rates of harvesting ≥5 LNSs or 3/1 LNS for SG (P = .002 and P = .003, respectively).

Conclusions: WR and SG have low rates of adequate LN harvesting. Robot-assisted surgery was associated with improved LN harvesting rates. Given the increase interest in sublobar resections, continued focus on improving and increasing LN harvesting are needed.

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在全州质量合作组织中评估叶状体下切除术中的淋巴结采集。

目的：评价叶下切除（SLR）治疗周围性非小细胞肺癌（NSCLC）的效果。方法：回顾性分析2015年1月至2023年3月在全州21个质量协作中心接受楔形切除术（WR）和节段切除术（SG）的非小细胞肺癌患者的前瞻性数据。主要终点是淋巴结（LN）收获的程度，定义为≥10个淋巴结，≥5个淋巴结站（LNs），或3个纵隔淋巴结和1个肺门淋巴结（3/1个LNs）。我们还检查了手术入路（开放，视频辅助（VATS），机器人辅助（RATS））分层的LN收获。结果：共纳入1398例SLR患者：WR组919例（65.7%），SG组479例（34.3%）。只有15.6%（152只）的WR和54.6%（263只）的SG收获了足够数量的LNS。与WR的VATS相比，RATS与≥10个LNs的收获率（p < 0.001）或≥5个LNs或3/1个LNs的收获率（p < 0.001）相关。与开放式手术和VATS相比，RATS与≥5个LNS或3/1个LNS的SG收获率较高相关(p = 0.002；P = 0.003)。结论：WR和SG的LN采收率较低。机器人手术可以提高LN的采收率。鉴于人们对单反相机的兴趣日益浓厚，需要继续关注改进和增加LN采集。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Thoracic and Cardiovascular Surgery 医学-呼吸系统

CiteScore

11.20

自引率

10.00%

发文量

1079

审稿时长

68 days

期刊介绍： The Journal of Thoracic and Cardiovascular Surgery presents original, peer-reviewed articles on diseases of the heart, great vessels, lungs and thorax with emphasis on surgical interventions. An official publication of The American Association for Thoracic Surgery and The Western Thoracic Surgical Association, the Journal focuses on techniques and developments in acquired cardiac surgery, congenital cardiac repair, thoracic procedures, heart and lung transplantation, mechanical circulatory support and other procedures.