The experience of video-assisted thoracoscopic lobectomies.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Kasper Steen, Morten Bendixen, Thomas Decker Christensen
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引用次数: 0

Abstract

Introduction: Video-assisted thoracoscopic surgery (VATS) lobectomy is increasingly replacing open thoracotomy as the standard surgical treatment for early-stage non-small cell lung cancer owing to its greater efficacy, as demonstrated in RCTs. This study aimed to examine the effectiveness and evolution of lung cancer treatment by VATS lobectomy in a single centre.

Methods: This retrospective single-centre cohort study at the Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark, examined operative reports for all VATS lobectomies performed in-house from 3 March 2008 to 6 July 2023, as well as medical records at one-year follow-up for 10% of the patients.

Results: VATS lobectomies were identified (N = 1,705). A steady annual increase in performed procedures and the number of performing surgeons was observed, and more frail patients underwent the procedure. Operation time, mean chest tube drainage time, length of hospitalisation and rate of annual conversions declined along with the amount and severity of post-operative complications, cancer recurrence and mortality at the one-year follow-up.

Conclusions: Treatment effectiveness, measured by peri- and post-operative outcomes, aligned with the efficiency presented in RCTs, with significant benefits of VATS compared to traditional anterolateral thoracotomy. Furthermore, treatment effectiveness evolved during the study period, and the introduction and training of new surgeons improved, enhancing the quality and availability of VATS throughout the period.

Funding: None.

Trial registration: Not relevant.

电视胸腔镜肺叶切除术的经验。
视频胸腔镜手术(VATS)肺叶切除术越来越多地取代开胸手术,成为早期非小细胞肺癌的标准手术治疗方法,因为rct显示其更有效。本研究旨在探讨单中心VATS肺叶切除术治疗肺癌的有效性和进展。方法:这项在丹麦奥胡斯大学医院心胸血管外科进行的回顾性单中心队列研究,检查了2008年3月3日至2023年7月6日在医院内进行的所有VATS肺叶切除术的手术报告,以及10%患者一年随访时的医疗记录。结果:发现VATS肺叶切除术(N = 1,705)。手术数量和外科医生数量每年都在稳步增长,越来越多体弱多病的病人接受了手术。手术时间、平均胸管引流时间、住院时间、年转换率随术后并发症的数量和严重程度、肿瘤复发率、1年随访死亡率而下降。结论:通过围手术期和术后结果衡量的治疗效果与随机对照试验中显示的效率一致,与传统的前外侧开胸术相比,VATS具有显著的优势。此外,在研究期间,治疗效果发生了变化,新外科医生的引进和培训得到了改善,提高了整个研究期间VATS的质量和可用性。资金:没有。试验注册:不相关。
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来源期刊
Danish medical journal
Danish medical journal MEDICINE, GENERAL & INTERNAL-
CiteScore
2.30
自引率
6.20%
发文量
78
审稿时长
3-8 weeks
期刊介绍: The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.
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