Video-assisted thoracoscopic surgery yields better outcomes than thoracotomy for anatomical lung resection in Brazil: a propensity score-matching analysis using the Brazilian Society of Thoracic Surgery database
Carregando...
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2018
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS INC
Autores
TSUKAZAN, Maria Teresa Ruiz
VIGO, Alvaro
FORTUNATO, Gustavo Almeida
CAMARGO, Spencer Marcantonio
OLIVEIRA, Humberto Alves de
GOMES NETO, Antero
PINTO FILHO, Darcy Ribeiro
Citação
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, v.53, n.5, p.993-998, 2018
Resumo
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.
Palavras-chave
Lobectomy, Video-assisted thoracoscopic surgery, Thoracotomy, Morbidity, Database
Referências
- Austin PC, 2006, STAT MED, V25, P2084, DOI 10.1002/sim.2328
- Bendixen M, 2016, LANCET ONCOL, V17, P836, DOI 10.1016/S1470-2045(16)00173-X
- Boffa DJ, 2008, J THORAC CARDIOV SUR, V135, P247, DOI 10.1016/j.jtcvs.2007.07.060
- Ceppa DP, 2012, ANN SURG, V256, P487, DOI 10.1097/SLA.0b013e318265819c
- Falcoz PE, 2016, EUR J CARDIO-THORAC, V49, P602, DOI 10.1093/ejcts/ezv154
- Fernandez FG, 2015, ANN THORAC SURG, V99, P368, DOI 10.1016/j.athoracsur.2014.05.104
- Gopaldas RR, 2010, ANN THORAC SURG, V89, P1563, DOI 10.1016/j.athoracsur.2010.02.026
- KIRBY TJ, 1995, J THORAC CARDIOV SUR, V109, P997, DOI 10.1016/S0022-5223(95)70326-8
- KIRBY TJ, 1993, ANN THORAC SURG, V56, P1248, DOI 10.1016/0003-4975(93)90661-Z
- Laursen LO, 2016, EUR J CARDIO-THORAC, V49, P870, DOI 10.1093/ejcts/ezv205
- McKenna RJ, 2006, ANN THORAC SURG, V81, P421, DOI 10.1016/j.athoracsur.2005.07.078
- Overhage JM, 2013, STAT METHODS MED RES, V22, P7, DOI 10.1177/0962280211403598
- Parsons LS, 2004, P 29 ANN SAS US GROU
- Paul S, 2010, J THORAC CARDIOV SUR, V139, P366, DOI 10.1016/j.jtcvs.2009.08.026
- Schmidt MI, 2011, LANCET, V377, P1949, DOI 10.1016/S0140-6736(11)60135-9
- Swanson SJ, 2012, ANN THORAC SURG, V93, P1027, DOI 10.1016/j.athoracsur.2011.06.007
- Terra RM, 2016, J BRAS PNEUMOL, V42, P215, DOI 10.1590/S1806-37562015000000337
- Wakeam E, 2015, ANN THORAC SURG, V100, P939, DOI 10.1016/j.athoracsur.2015.03.076
- WALKER WS, 1993, THORAX, V48, P921, DOI 10.1136/thx.48.9.921