Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12510

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    P3.07-015 - Robotic-Assisted Pulmonary Resection for Non-Small Cell Lung Cancer in High Risk Veteran Population: A Single Institution Experience (ID 1488)

    09:30 - 09:30  |  Author(s): V. Kirkpatrick
    • Abstract

    Background
    The value of robotics in surgical treatment of lung cancer is not well-defined. Our goal was to examine the surgical results of robotic-assisted pulmonary resections in a high risk profile veteran population. .

    Methods
    A retrospective analysis of a single VA facility’s robotic thoracic surgical experience from January 2011 to May 2013 was performed. A total of 70 consecutive patients had undergone robotic pulmonary resections, by a single surgeon, for treatment of non-small cell lung cancer (NSCLC). All preoperative, intra- and postoperative data including length of stay (LOS) and readmission rates were collected.

    Results
    60 lobar and 10 sublobar (wedge) pulmonary resections plus mediastinal/hilar lymph node staging had been performed. Mean number of lymph node stations sampled were 3.5 (range 2-7). Mean age was 68 (40-86). 33 (47%) patients were active smokers. 42 (60%) patients had hypertension, 34 (48%) had COPD, 15 (21%) had BMI >30, 14 (20%) had DM, 13 (19%) had documented coronary artery disease, 11 (16%) had history of alcohol abuse, 7 (11%) had renal insufficiency defined as creatinine > 1.3, and 3 (4%) had received induction therapy. Average preoperative FEV1 and DLCO were 76% and 68% of predicted, respectively. Stage distribution is shown in Table 1. Intra- and postoperative data are summarized in Table 2. Thirty day mortality was 1.4% (1). 20 patients sustained at least one complication (28.5% morbidity). Mean LOS for the entire cohort was 7 days; mean LOS for those 57 patients having undergone completely robotic resection was 6 days. Prolonged air leak was the most prevalent reason for an extended LOS. Table 1: Clinical and pathologic stage distribution.

    Total N=70	Clinical Stage : N(%)	Pathologic Stage: N(%)
    Ia	49 (70%)	34 (48.6%)
    Ib	6 (8.6%)	16 (22.9%)
    IIa	8 (11.4%)	6 (8.6%)
    IIb	3 (4.3%)	4 (5.7%)
    IIIa	3 (4.3%)	9 (12.8%)
    IIIb	0	0
    IVa	0	0
    IVb	1 (1.4%)	1 (1.4%)

    Table 2: Intraoperative and postoperative outcomes

    	N	%
    Intraoperative data
    OR extubation	66	94
    Conversion to open	13	18
    Blood transfusion	1	1.4
    Death	0	0
    Average EBL	83
    Postoperative data
    Atrial fibrillation	10	14
    Bronchoscopy	9	12.8
    Prolonged air leak (>7days)	8	11.4
    Blood transfusion	7	10
    Pneumonia	5	7.1
    Respiratory failure (reintubation)	2	2.8
    Reoperation within 30 days	2	2.8
    Readmission within 30 days	2	2.8
    Pulmonary embolism	1	1.4
    DVT	1	1.4
    Average Chest Tube Days	4.1

    EBL: estimated blood loss; DVT: deep vein thrombosis

    Conclusion
    This is the first report on feasibility and outcome of robotic thoracic surgery in a high risk veteran population. Our data suggest that robotic-assisted pulmonary resection for NSCLC can be performed with acceptable morbidity and mortality in this cohort.