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J. Fontaine
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P1.08 - Poster Session with Presenters Present (ID 460)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 2
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.08-044 - Comparison of Peri-Operative Outcomes after Robotic-Assisted Video-Thoracoscopic Lobectomies versus Segmentectomies (ID 5259)
14:30 - 14:30 | Author(s): J. Fontaine
- Abstract
Background:
Lobectomy is the standard procedure for early stage lung cancer. The role of sub-lobar resection is currently under investigation. Published comparisons between VATS, R-VATS, and open lobectomy vs. segmentectomy have been reported. The goal of our study was to compare peri-operative outcomes after R-VATS lobectomy vs segmentectomy. Comparison between these two procedures using robotic instruments has not been published.
Methods:
We retrospectively analyzed prospectively collected data from 253 consecutive patients who underwent lobectomy(N=208) and segmentectomy(N=45) via R-VATS performed by one surgeon. Unpaired Student’s t-test and Chi-square test were used to determine statistical significance(p≤ 0.05) of intra- and post-operative outcomes between these 2 groups.
Results:
Figure 1Figure 2 No significant difference was found on intra-operative complications (18/208 vs. 4/43; p=0.70). However, the mean duration of R-VATS segmentectomy was longer than lobectomy(258min vs. 207.5min: p<0.01). Total post-operative complications didn't differ between the groups(24/43 vs. 84/208; p=0.071). Individual complications reviewed included cardiovascular, wound infections, and respiratory adverse outcomes. Only pneumothorax after chest tube removal(p=0.032) and effusion/empyema(p=0.011) requiring intervention were significant.
Conclusion:
R-VATS segmentectomy on average take longer and has more postoperative complications which can be explained by patients' underlying pulmonary disease. R-VATS segmentectomy may be considered as an alternative procedure to R-VATS lobectomy in order to conserve lung function.
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P1.08-048 - Comparison of Pulmonary Function after Robotic-Assisted Video-Thoracoscopic Lobectomies vs Segmentectomies (ID 5258)
14:30 - 14:30 | Author(s): J. Fontaine
- Abstract
Background:
Lobectomy is the standard surgical procedure for early stage lung cancer, but sub-lobar resection is being debated. We compared pulmonary function after robotic-assisted video-assisted Thoracoscopic (R-VATS) segmentectomy versus lobectomy; comparison using robotic instruments hasn't been published.
Methods:
We retrospectively analyzed prospectively collected data from 251 consecutive patients who underwent lobectomy (N=208) and segmentectomy (N=43) via R-VATS by one surgeon. Unpaired Student's t-test and Chi-square tests were used to determine statistical significance(p≤ 0.05). Majority of patients had no prior lung surgery. We used “Predicted(PFT)=Preop(PFT)x(1-(Segments x 0.0556))”, where 0.0556=1seg/18seg. For patients with prior resections, the number of segments previously resected was taken into account(1seg/(18-Prior resection)).
Results:
Figure 1Figure 2Preoperative FEV1(%) and DLCO(%) were statistically significant between the two groups. Also, FEV1 and DLCO were lower in segmentectomy patients. As expected, predicted changes between preoperative and postoperative values were significant. Predicted post-operative FEV1 and DLCO did not show any significant difference between the two groups.
Conclusion:
While pre-operative PFTs were significantly lower in segmentectomy patients compared to lobectomy patients, predicted post-operative PFTs do not differ significantly. Predicted changes for FEV1 and DLCO are significantly less in segmentectomy. Thus, negate the difference in pre-operative PFTs. In conclusion, R-VATS segmentectomy preserves lung function and may be considered a viable alternative
