Maria Teresa Ruiz Tsukazan1, Ricardo Mingarini Terra2, Álvaro Vigo3, Gustavo Almeida Fortunato4, Spencer Marcantonio Camargo5, Humberto Alves de Oliveira6, Antero Gomes Neto7,8, Darcy Ribeiro Pinto Filho9. 1. Division of Thoracic Surgery, Hospital São Lucas Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil. 2. Division of Thoracic Surgery, Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto do Coração, São Paulo, Brazil. 3. Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 4. Division of Thoracic Surgery, Santa Casa de Misericórdia da Bahia, Salvador, Brazil. 5. Division of Thoracic Surgery, Hospital Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil. 6. Department of Thoracic Surgery, Hospital Federal de Base do Distrito Federal, Brasília, Brazil. 7. Department of Thoracic Surgery, Hospital de Messejana, Fortaleza, Brazil. 8. Department of Surgery, Universidade Federal do Ceará, Fortaleza, Brazil. 9. Department of Thoracic Surgery, Universidade de Caxias do Sul, Caxias do Sul, Brazil.
Abstract
OBJECTIVES: The use of video-assisted anatomical lung resection is increasingly widespread for lung cancer and non-neoplastic diseases, showing excellent results. Nonetheless, a comparative analysis of the benefits of this technique has yet to be conducted in Latin America, a region with a completely different case mix from the USA or Europe. The purpose of this study was to compare the outcomes of video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) for anatomical lung resection in patients included on the Brazilian Society of Thoracic Surgery (BSTS) database. METHODS: Using propensity score matching, we conducted an analysis of 1355 patients who underwent anatomical lung resection (704 OT and 651 VATS) registered in the BSTS database between August 2015 and December 2016. Propensity score matching was performed using the following baseline characteristics: age at surgery, gender, comorbidities, pulmonary lung function, type of resection and cancer and non-cancer diagnosis. The propensity score-matched sample comprised a well-matched group of 890 patients. The main outcomes tested were mortality, complications and major cardiopulmonary complications based on the European Society of Thoracic Surgeons (ESTS) database definitions and terminology. RESULTS: Standardized differences of means and proportions suggested that an adequate balance had been achieved. Major cardiopulmonary complications were shown to be more frequent in patients who underwent OT (16.0% compared with 9.2% in VATS patients; odds ratio = 1.87, 95% confidence interval 1.25-2.80) and the overall complications rate was higher among patients who underwent OT (30.1% compared with 21.8% in VATS patients; odds ratio = 1.55, 95% confidence interval 1.17-2.05). No statistically significant difference in mortality rate was observed between OT (2.5%) and VATS (1.8%) (odds ratio = 1.38, 95% confidence interval 0.54-3.50). CONCLUSIONS: In Brazil, the rate of complications associated with minimally invasive surgery (VATS) for anatomical lung resection is significantly lower than that of conventional OT.
OBJECTIVES: The use of video-assisted anatomical lung resection is increasingly widespread for lung cancer and non-neoplastic diseases, showing excellent results. Nonetheless, a comparative analysis of the benefits of this technique has yet to be conducted in Latin America, a region with a completely different case mix from the USA or Europe. The purpose of this study was to compare the outcomes of video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) for anatomical lung resection in patients included on the Brazilian Society of Thoracic Surgery (BSTS) database. METHODS: Using propensity score matching, we conducted an analysis of 1355 patients who underwent anatomical lung resection (704 OT and 651 VATS) registered in the BSTS database between August 2015 and December 2016. Propensity score matching was performed using the following baseline characteristics: age at surgery, gender, comorbidities, pulmonary lung function, type of resection and cancer and non-cancer diagnosis. The propensity score-matched sample comprised a well-matched group of 890 patients. The main outcomes tested were mortality, complications and major cardiopulmonary complications based on the European Society of Thoracic Surgeons (ESTS) database definitions and terminology. RESULTS: Standardized differences of means and proportions suggested that an adequate balance had been achieved. Major cardiopulmonary complications were shown to be more frequent in patients who underwent OT (16.0% compared with 9.2% in VATS patients; odds ratio = 1.87, 95% confidence interval 1.25-2.80) and the overall complications rate was higher among patients who underwent OT (30.1% compared with 21.8% in VATS patients; odds ratio = 1.55, 95% confidence interval 1.17-2.05). No statistically significant difference in mortality rate was observed between OT (2.5%) and VATS (1.8%) (odds ratio = 1.38, 95% confidence interval 0.54-3.50). CONCLUSIONS: In Brazil, the rate of complications associated with minimally invasive surgery (VATS) for anatomical lung resection is significantly lower than that of conventional OT.
Authors: Ricardo Mingarini Terra; Rui Haddad; José Ribas Milanese de Campos; Pedro Henrique Xavier Nabuco de Araújo; Carlos Eduardo Teixeira Lima; Felipe Braga; Benoit Jacques Bibas; Juliana Mol Trindade; Leticia Leone Lauricella; Paulo Manuel Pêgo-Fernandes Journal: World J Surg Date: 2019-11 Impact factor: 3.352
Authors: Ricardo Mingarini Terra; Pedro Henrique Xavier Nabuco de Araujo; Leticia Leone Lauricella; Jose Ribas Milanese de Campos; Juliana Rocha Mol Trindade; Paulo Manuel Pêgo-Fernandes Journal: J Bras Pneumol Date: 2022-07-08 Impact factor: 2.800
Authors: Ricardo Mingarini Terra; Benoit Jacques Bibas; Rui Haddad; José Ribas Milanez-de-Campos; Pedro Henrique Xavier Nabuco-de-Araujo; Carlos Eduardo Teixeira-Lima; Felipe Braga Dos Santos; Leticia Leone Lauricella; Paulo Manuel Pêgo-Fernandes Journal: J Bras Pneumol Date: 2019-12-13 Impact factor: 2.624