دورية أكاديمية
أعرض في EDS

Trends and Comparative Outcomes Between Operative Approaches for Segmentectomy in Lung Cancer.

التفاصيل البيبلوغرافية
العنوان: Trends and Comparative Outcomes Between Operative Approaches for Segmentectomy in Lung Cancer.
المؤلفون: Watkins AA; Division of Thoracic and Cardiovascular Surgery,; Tufts University School of Medicine, Boston, MA., Rizvi TZ; Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA;; Tufts University School of Medicine, Boston, MA., Lopez E; Division of Thoracic and Cardiovascular Surgery., Shehata D; Division of Thoracic and Cardiovascular Surgery., Ssemaganda H; Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA., Lin Z; Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA., Stock CT; Division of Thoracic and Cardiovascular Surgery,; Tufts University School of Medicine, Boston, MA., Moffatt-Bruce SD; Division of Thoracic and Cardiovascular Surgery,; Tufts University School of Medicine, Boston, MA;; UMass Chan Medical School, Worcester, MA., Servais EL; Division of Thoracic and Cardiovascular Surgery,; Tufts University School of Medicine, Boston, MA;; UMass Chan Medical School, Worcester, MA. Electronic address: Elliot.Servais@lahey.org.
المصدر: The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2024 Jul 11. Date of Electronic Publication: 2024 Jul 11.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: St. Louis, MO : Mosby
Original Publication: St. Louis.
مستخلص: Background: Segmentectomy is increasingly performed for non-small cell lung cancer (NSCLC). However, comparative outcomes data between open, robotic-assisted (RATS) and video-assisted thoracoscopic (VATS) approaches are limited.
Methods: A retrospective cohort study of NSCLC segmentectomy cases (2013-2021) from the Society of Thoracic Surgeons General Thoracic Surgery Database was performed. Baseline characteristics were balanced using inverse probability of treatment weighting and compared by operative approach. Volume trends, outcomes, and nodal upstaging were assessed.
Results: Of 9,927 segmentectomy patients, 84.8% underwent minimally invasive surgery (MIS), with RATS becoming the most common approach in 2019. Open segmentectomy is more likely performed at low-volume centers (p<0.0001), whereas RATS more likely high-volume centers (p<0.0001). VATS had higher open conversion rate than RATS (OR 11.8, CI [7.01-21.6], p<0.001). MIS had less 30-day morbidity compared to open segmentectomy (VATS OR 0.71 95% CI [0.55-0.94], p=0.013; RATS OR 0.59, CI [0.43-0.81], p=0.001). Number of nodes and stations harvested were highest for RATS, however N1 upstaging was more likely in open compared to RATS (OR 0.63, CI 0.45-0.89, p< 0.007) and VATS (OR 0.61, CI 0.46-0.83, p=0.001).
Conclusions: Segmentectomy volume has increased considerably with RATS becoming the most common approach. MIS has less major morbidity compared to open segmentectomy with no difference between VATS and RATS. However, risk of open conversion is higher with VATS. RATS had increased nodal harvest whereas hilar nodal upstaging was highest with thoracotomy. This study reveals significant differences in outcomes exist between segmentectomy operative approach; the impact of approach on survival merits further investigation.
(Copyright © 2024. Published by Elsevier Inc.)
فهرسة مساهمة: Keywords: Lung cancer; lung surgery; segmentectomy; thoracic oncology; thoracic surgery
تواريخ الأحداث: Date Created: 20240713 Latest Revision: 20240713
رمز التحديث: 20240714
DOI: 10.1016/j.jtcvs.2024.07.005
PMID: 39002852
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-685X
DOI:10.1016/j.jtcvs.2024.07.005