1. VATS lobectomy morbidity and mortality is lower in patients with the same ppoDLCO: Analysis of the database of the Spanish Video-Assisted Thoracic Surgery Group
- Author
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Borja Aguinagalde, Asier Insausti, Iker Lopez, Laura Sanchez, Sergio Bolufer, Raul Embun, Iñigo Royo-Crespo, José Luis Recuero Díaz, Sergi Call, Miguel Congregado, David Gómez-de Antonio, Marcelo F. Jimenez, Nicolas Moreno-Mata, Sergio Amor-Alonso, Miguel Jesús Arrarás, Ana Isabel Blanco Orozco, Marc Boada, Alberto Cabañero Sánchez, Isabel Cal Vázquez, Ángel Cilleruelo Ramos, Silvana Crowley Carrasco, Elena Fernández-Martín, Santiago García-Barajas, Maria Dolores García-Jiménez, Jose María García-Prim, Jose Alberto Garcia-Salcedo, Juan José Gelbenzu-Zazpe, Carlos Fernando Giraldo-Ospina, María Teresa Gómez Hernández, Jorge Hernández, Jennifer D. Illana Wolf, Alberto Jauregui Abularach, Unai Jiménez, Iker López Sanz, Néstor J. Martínez-Hernández, Elisabeth Martínez-Téllez, Lucía Milla Collado, Roberto Mongil Poce, Francisco Javier Moradiellos-Díez, Ramón Moreno-Balsalobre, Sergio B. Moreno Merino, Carme Obiols, Florencio Quero-Valenzuela, María Elena Ramírez-Gil, Ricard Ramos-Izquierdo, Eduardo Rivo, Alberto Rodríguez-Fuster, Rafael Rojo-Marcos, David Sanchez-Lorente, Laura Sanchez Moreno, Carlos Simón, Juan Carlos Trujillo-Reyes, Florentino Hernando Trancho, Cipriano López, Juan José Fibla, and Julio Sesma
- Subjects
Lung cancer surgery ,medicine.medical_specialty ,Lung Neoplasms ,business.industry ,Thoracic Surgery, Video-Assisted ,medicine.medical_treatment ,VATS lobectomy ,General Medicine ,medicine.disease ,Surgery ,Treatment Outcome ,Thoracotomy ,Cardiothoracic surgery ,Relative risk ,Propensity score matching ,medicine ,Risk of mortality ,Humans ,Morbidity ,Lung cancer ,business ,Pneumonectomy ,Retrospective Studies - Abstract
Measuring predicted post-operative diffusion capacity of the lung for carbon monoxide (ppoDLCO) is essential to determine patient operability and to stratify the risk of patients who are candidates for major lung cancer surgery. Studies that established surgical risk variables were based on open surgery series. The aim of our study was to analyze morbidity and mortality as a function of ppoDLCO and to compare its behavior in open and video-assisted thoracic surgery (VATS).We compared 90-day mortality and morbidity in patients undergoing open surgery versus VATS as a function of decline in ppoDLCO. Propensity score matching (using age, ASA, arterial vascular disease, BMI, gender, stage, ppoDLCO, and ppoFEVOf 2,530 patients with lung cancer and ppoDLCO values, a sample of 1,624 (812 per group) was obtained after score matching. The relative risk of mortality associated with thoracotomy in patients with ppoDLCO 60 is 2.66 (p 0.02) compared to VATS. The risk of thoracotomy in terms of overall and cardiac and respiratory morbidity is higher than that of VATS for almost all ppoDLCO values.Major resection by VATS shows lower morbidity and mortality in patients with the same ppoDLCO. A steady rise in the risk of mortality begins to occur at higher ppoDLCO values in thoracotomy (∼60) than in VATS (∼45).
- Published
- 2020