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A. Poch



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    P1.08 - Poster Session with Presenters Present (ID 460)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P1.08-047 - Decreasing Use of Epidural Analgesia with Increasing Minimally Invasive Lobectomy: Impact on Postoperative Morbidity (ID 4941)

      14:30 - 14:30  |  Author(s): A. Poch

      • Abstract
      • Slides

      Background:
      The goal of this study is to assess the impact of the decreasing use of epidural analgesia (infusion ≥24 hours) on the incidence of postoperative morbidity following minimally invasive surgical (MIS; includes VATS and robotic-assisted) lobectomy in patients with non-small cell lung cancer (NSCLC).

      Methods:
      We reviewed 1206 patients who underwent MIS lobectomy for pathological stage I-III NSCLC in 2009-10 (n=506) and 2014-15 (n=700) at our institution. Clinical data was obtained from a prospectively maintained database and by review of individual patient medical records. Patients with induction therapy (n=225) or conversion from MIS to thoracotomy (n=99) were excluded. Postoperative morbidity (≤30 days) was graded based on the Common Terminology Criteria for Adverse Events (CTCAE). Statistical comparison was performed using Chi-squared analysis and Fisher’s exact test.

      Results:
      A total of 884 patients were included in this study (2009-10, n=401; 2014-15, n=483). The rate of MIS lobectomy significantly increased in 2014-15 compared to 2009-10 (74% vs. 53%, p<0.001) with a simultaneous decrease in the use of epidural analgesia (92.9% vs. 53.6%, p<0.001; Figure 1A and 1B). In the MIS group, there was no difference in age, sex, or pathological stage between the 2009-10 and 2014-15 cohorts. There was no significant change in the incidence of any, severe respiratory or cardiovascular morbidity (CTCAE grade ≥3) following MIS lobectomy between the two time periods evaluated (Figure 1C). However, the incidence of CTCAE grade ≥2 respiratory morbidity in 2014-15 was higher than that in 2009-10 (7.1% vs. 12.6%, p=0.047).Figure 1



      Conclusion:
      In our study cohort, the observed decrease in use of epidural analgesia with the increasing rate of MIS lobectomy did not affect the incidence of severe postoperative morbidity.

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