Martin Reichert1, Andrea Birgitta Gohlke2, Florian Augustin3, Dietmar Öfner3, Andreas Hecker2, Winfried Padberg2, Johannes Bodner2,3,4. 1. Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim Strasse 7, 35392, Giessen, Germany. martin.reichert@chiru.med.uni-giessen.de. 2. Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim Strasse 7, 35392, Giessen, Germany. 3. Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria. 4. Department of Thoracic Surgery, Klinikum Bogenhausen, Englschalkinger Strasse 77, 81925, Munich, Germany.
Abstract
PURPOSE: Video-assisted thoracoscopic surgery (VATS) is an accepted alternative to thoracotomy for anatomic lung resection (AR) and literature suggests benefits over the conventional open approach. However, it's routine clinical application is still low and varies within different countries. METHODS: Nationwide survey among thoracic surgical units in Germany, evaluating the departmental structure, volume of the VATS program, experience with VATS-AR (lobectomies and other-than-lobectomies-anatomic-resections), surgical technique and learning curve data. RESULTS: Response rate among the 269 surgical units practicing thoracic surgery in Germany was 84.4 % (n = 227). One hundred twenty-two (53.7 %) units do have experience with any type of VATS-AR. The majority of units started the VATS program only within the last 5 years and 17.2 % (n = 21) of the units have performed more than 100 procedures by now. In 2013, 78.7 % of the units performed less than 25 % of their institutional AR via a VATS approach. Indications for VATS-AR were non-small cell lung cancer in 93.4 % (up to UICC-stage IA, IB, IIA, IIB, IIIA in 7 %, 22.8 %, 33.3 %, 17.5 %, 7 %, respectively), benign diseases in 57.4 %, and pulmonary metastases in 50.8 %. 43.4 % of the departments had experience with extended VATS-AR and 28.7 % performed VATS-AR after induction-therapy. CONCLUSIONS: Every second thoracic surgical unit in Germany does have experience in VATS-AR though only about 20 % of them perform it routinely and also in extended procedures.
PURPOSE: Video-assisted thoracoscopic surgery (VATS) is an accepted alternative to thoracotomy for anatomic lung resection (AR) and literature suggests benefits over the conventional open approach. However, it's routine clinical application is still low and varies within different countries. METHODS: Nationwide survey among thoracic surgical units in Germany, evaluating the departmental structure, volume of the VATS program, experience with VATS-AR (lobectomies and other-than-lobectomies-anatomic-resections), surgical technique and learning curve data. RESULTS: Response rate among the 269 surgical units practicing thoracic surgery in Germany was 84.4 % (n = 227). One hundred twenty-two (53.7 %) units do have experience with any type of VATS-AR. The majority of units started the VATS program only within the last 5 years and 17.2 % (n = 21) of the units have performed more than 100 procedures by now. In 2013, 78.7 % of the units performed less than 25 % of their institutional AR via a VATS approach. Indications for VATS-AR were non-small cell lung cancer in 93.4 % (up to UICC-stage IA, IB, IIA, IIB, IIIA in 7 %, 22.8 %, 33.3 %, 17.5 %, 7 %, respectively), benign diseases in 57.4 %, and pulmonary metastases in 50.8 %. 43.4 % of the departments had experience with extended VATS-AR and 28.7 % performed VATS-AR after induction-therapy. CONCLUSIONS: Every second thoracic surgical unit in Germany does have experience in VATS-AR though only about 20 % of them perform it routinely and also in extended procedures.
Authors: Gaetano Rocco; Eveline Internullo; Stephen D Cassivi; Dirk Van Raemdonck; Mark K Ferguson Journal: Thorac Surg Clin Date: 2008-08 Impact factor: 1.750
Authors: Rebecca P Petersen; DuyKhanh Pham; William R Burfeind; Steven I Hanish; Eric M Toloza; David H Harpole; Thomas A D'Amico Journal: Ann Thorac Surg Date: 2007-04 Impact factor: 4.330
Authors: Paul De Leyn; Christophe Dooms; Jaroslaw Kuzdzal; Didier Lardinois; Bernward Passlick; Ramon Rami-Porta; Akif Turna; Paul Van Schil; Frederico Venuta; David Waller; Walter Weder; Marcin Zielinski Journal: Eur J Cardiothorac Surg Date: 2014-02-26 Impact factor: 4.191
Authors: Bryan A Whitson; Rafael S Andrade; Adam Boettcher; Ricardo Bardales; Robert A Kratzke; Peter S Dahlberg; Michael A Maddaus Journal: Ann Thorac Surg Date: 2007-06 Impact factor: 4.330