429 results on '"Petersen, René Horsleben"'
Search Results
152. Reply to Li and Verhagen
- Author
-
Decaluwe, Herbert, primary, Petersen, René Horsleben, additional, Hansen, Henrik, additional, and Gossot, Dominique, additional
- Published
- 2016
- Full Text
- View/download PDF
153. Cowden Syndrome and Concomitant Pulmonary Neuroendocrine Tumor:A Presentation of Two Cases
- Author
-
Langer, Seppo W, Ringholm, Lene, Dali, Christine I, Petersen, René Horsleben, Rasmussen, Åse Krogh, Gerdes, Anne-Marie, Federspiel, Birgitte, Knigge, Ulrich Peter, Langer, Seppo W, Ringholm, Lene, Dali, Christine I, Petersen, René Horsleben, Rasmussen, Åse Krogh, Gerdes, Anne-Marie, Federspiel, Birgitte, and Knigge, Ulrich Peter
- Abstract
Cowden Syndrome is a rare autosomal dominantly inherited disorder. Patients with Cowden Syndrome are at increased risk of various benign and malignant neoplasms in breast, endometrium, thyroid, gastrointestinal tract, and genitourinary system. Neuroendocrine tumors are ubiquitous neoplasms that may occur anywhere in the human body. Bronchopulmonary neuroendocrine tumors include four different histological subtypes, among these, typical and atypical pulmonary carcinoids. No association between Cowden Syndrome and neuroendocrine tumors has previously been described. We present two cases of Cowden Syndrome that were diagnosed with pulmonary carcinoids.
- Published
- 2015
154. A new possibility in thoracoscopic virtual reality simulation training:development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy
- Author
-
Jensen, Katrine, Bjerrum, Flemming, Hansen, Henrik Jessen, Petersen, René Horsleben, Pedersen, Jesper Holst, Konge, Lars, Jensen, Katrine, Bjerrum, Flemming, Hansen, Henrik Jessen, Petersen, René Horsleben, Pedersen, Jesper Holst, and Konge, Lars
- Abstract
OBJECTIVES: The aims of this study were to develop virtual reality simulation software for video-assisted thoracic surgery (VATS) lobectomy, to explore the opinions of thoracic surgeons concerning the VATS lobectomy simulator and to test the validity of the simulator metrics.METHODS: Experienced VATS surgeons worked with computer specialists to develop a VATS lobectomy software for a virtual reality simulator. Thoracic surgeons with different degrees of experience in VATS were enrolled at the 22nd meeting of the European Society of Thoracic Surgeons (ESTS) held in Copenhagen in June 2014. The surgeons were divided according to the number of performed VATS lobectomies: novices (0 VATS lobectomies), intermediates (1-49 VATS lobectomies) and experienced (>50 VATS lobectomies). The participants all performed a lobectomy of a right upper lobe on the simulator and answered a questionnaire regarding content validity. Metrics were compared between the three groups.RESULTS: We succeeded in developing the first version of a virtual reality VATS lobectomy simulator. A total of 103 thoracic surgeons completed the simulated lobectomy and were distributed as follows: novices n = 32, intermediates n = 45 and experienced n = 26. All groups rated the overall user realism of the VATS lobectomy scenario to a median of 5 on a scale 1-7, with 7 being the best score. The experienced surgeons found the graphics and movements realistic and rated the scenario high in terms of usefulness as a training tool for novice and intermediate experienced thoracic surgeons, but not very useful as a training tool for experienced surgeons. The metric scores were not statistically significant between groups.CONCLUSIONS: This is the first study to describe a commercially available virtual reality simulator for a VATS lobectomy. More than 100 thoracic surgeons found the simulator realistic, and hence it showed good content validity. However, none of the built-in simulator metrics
- Published
- 2015
155. Fast-track video-assisted thoracoscopic surgery: future challenges
- Author
-
Holbek, Bo Laksáfoss, primary, Petersen, René Horsleben, additional, Kehlet, Henrik, additional, and Hansen, Henrik Jessen, additional
- Published
- 2015
- Full Text
- View/download PDF
156. Major intraoperative complications during video-assisted thoracoscopic anatomical lung resections: an intention-to-treat analysis
- Author
-
Decaluwe, Herbert, primary, Petersen, René Horsleben, additional, Hansen, Henrik, additional, Piwkowski, Cezary, additional, Augustin, Florian, additional, Brunelli, Alessandro, additional, Schmid, Thomas, additional, Papagiannopoulos, Kostas, additional, Moons, Johnny, additional, and Gossot, Dominique, additional
- Published
- 2015
- Full Text
- View/download PDF
157. Diagnosis and treatment of bronchopulmonary neuroendocrine tumours: State of the art
- Author
-
Tabaksblat, Elizaveta Mitkina, primary, Langer, Seppo W., additional, Knigge, Ulrich, additional, Grønbæk, Henning, additional, Mortensen, Jann, additional, Petersen, René Horsleben, additional, Federspiel, Birgitte Hartnack, additional, and Ladekarl, Morten, additional
- Published
- 2015
- Full Text
- View/download PDF
158. A new possibility in thoracoscopic virtual reality simulation training: development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy
- Author
-
Jensen, Katrine, primary, Bjerrum, Flemming, additional, Hansen, Henrik Jessen, additional, Petersen, René Horsleben, additional, Pedersen, Jesper Holst, additional, and Konge, Lars, additional
- Published
- 2015
- Full Text
- View/download PDF
159. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy
- Author
-
Laursen, Lykke Østergaard, primary, Petersen, René Horsleben, additional, Hansen, Henrik Jessen, additional, Jensen, Tina Kold, additional, Ravn, Jesper, additional, and Konge, Lars, additional
- Published
- 2015
- Full Text
- View/download PDF
160. Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database
- Author
-
Falcoz, Pierre-Emmanuel, primary, Puyraveau, Marc, additional, Thomas, Pascal-Alexandre, additional, Decaluwe, Herbert, additional, Hürtgen, Martin, additional, Petersen, René Horsleben, additional, Hansen, Henrik, additional, and Brunelli, Alessandro, additional
- Published
- 2015
- Full Text
- View/download PDF
161. Uventet fund af endobronkial lungetumor ved bronkoskopi hos en storryger
- Author
-
Gottlieb, Magnus, Clementsen, Paul Frost, Håkansson, Kåre, Petersen, René Horsleben, Konge, Lars, Gottlieb, Magnus, Clementsen, Paul Frost, Håkansson, Kåre, Petersen, René Horsleben, and Konge, Lars
- Abstract
A 60-year-old male heavy smoker surprisingly presented with a squamous cell carcinoma in the right upper lobe at bronchoscopy. Combined PET-CT classified the lung cancer as T1aN0M0. However, the endoscopic classification was T2a, which radically reversed the treatment schedule. Conclusions: 1) A careful bronchoscopy is important even in cases where lung cancer is not expected. 2) Accurate endobronchial classification can be crucial. 3) There is need for training requirements to obtain a satisfactory level of competence in bronchoscopy.
- Published
- 2014
162. Simulation-based training for thoracoscopic lobectomy:a randomized controlled trial: virtual-reality versus black-box simulation
- Author
-
Jensen, Katrine, Ringsted, Charlotte, Hansen, Henrik Jessen, Petersen, René Horsleben, Konge, Lars, Jensen, Katrine, Ringsted, Charlotte, Hansen, Henrik Jessen, Petersen, René Horsleben, and Konge, Lars
- Abstract
BACKGROUND: Video-assisted thoracic surgery is gradually replacing conventional open thoracotomy as the method of choice for the treatment of early-stage non-small cell lung cancers, and thoracic surgical trainees must learn and master this technique. Simulation-based training could help trainees overcome the first part of the learning curve, but no virtual-reality simulators for thoracoscopy are commercially available. This study aimed to investigate whether training on a laparoscopic simulator enables trainees to perform a thoracoscopic lobectomy.METHODS: Twenty-eight surgical residents were randomized to either virtual-reality training on a nephrectomy module or traditional black-box simulator training. After a retention period they performed a thoracoscopic lobectomy on a porcine model and their performance was scored using a previously validated assessment tool.RESULTS: The groups did not differ in age or gender. All participants were able to complete the lobectomy. The performance of the black-box group was significantly faster during the test scenario than the virtual-reality group: 26.6 min (SD 6.7 min) versus 32.7 min (SD 7.5 min). No difference existed between the two groups when comparing bleeding and anatomical and non-anatomical errors.CONCLUSION: Simulation-based training and targeted instructions enabled the trainees to perform a simulated thoracoscopic lobectomy. Traditional black-box training was more effective than virtual-reality laparoscopy training. Thus, a dedicated simulator for thoracoscopy should be available before establishing systematic virtual-reality training programs for trainees in thoracic surgery.
- Published
- 2014
163. Development and validation of a theoretical test of proficiency for video-assisted thoracoscopic surgery (VATS) lobectomy
- Author
-
Savran, Mona Meral, primary, Hansen, Henrik Jessen, additional, Petersen, René Horsleben, additional, Walker, William, additional, Schmid, Thomas, additional, Bojsen, Signe Rolskov, additional, and Konge, Lars, additional
- Published
- 2014
- Full Text
- View/download PDF
164. Impact of Examined Lymph Node Count on Precise Staging and Long-Term Survival of Resected Non-Small-Cell Lung Cancer: A Population Study of the US SEER Database and a Chinese Multi-Institutional Registry.
- Author
-
Wenhua Liang, Jiaxi He, Yaxing Shen, Jianfei Shen, Qihua He, Jianrong Zhang, Gening Jiang, Qun Wang, Lunxu Liu, Shugeng Gao, Deruo Liu, Zheng Wang, Zhihua Zhu, Ng, Calvin S.H., Chia-chuan Liu, Petersen, René Horsleben, Rocco, Gaetano, D'Amico, Thomas, Brunelli, Alessandro, and Haiquan Chen
- Published
- 2017
- Full Text
- View/download PDF
165. Regional analgesia for video-assisted thoracic surgery – a systematic review
- Author
-
Julia Steinthorsdottir, Kristin, Wildgaard, Lorna, Jessen Hansen, Henrik, Petersen, René Horsleben, Wildgaard, Kim, Julia Steinthorsdottir, Kristin, Wildgaard, Lorna, Jessen Hansen, Henrik, Petersen, René Horsleben, and Wildgaard, Kim
- Abstract
Video-assisted thoracic surgery (VATS) is emerging as the standard surgical procedure for both minor and major oncologic lung surgery. Thoracic epidural analgesia (TEA) and paravertebral block (PVB) are established analgesic golden standards for open surgery such as thoracotomy; however there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques in regards to effect on acute post-operative pain following VATS, with emphasis on VATS lobectomy. The systematic review of the PubMed, Cochrane Library and Embase databases yielded unique 1542 abstracts, 17 articles were included for qualitative assessment, of which 3 were studies on VATS lobectomy. The analgesic techniques included TEA, multilevel- and single PVB, paravertebral catheter, intercostal catheter, interpleural infusion and long thoracic nerve block. Overall the studies were heterogeneous with small numbers of participants. In comparative studies TEA and especially PVB showed some effect on pain scores, but were often compared to inferior analgesic treatment. Other techniques showed no unequivocal results. No clear gold standard for regional analgesia for VATS could be demonstrated, but a guide of factors to include in future studies on regional analgesia for VATS is presented.
- Published
- 2013
166. Simulation-Based Training for Thoracoscopy
- Author
-
Bjurström, Johanna Margareta, Konge, Lars, Lehnert, Per, Krogh, Charlotte Loumann, Hansen, Henrik Jessen, Petersen, René Horsleben, Ringsted, Charlotte, Bjurström, Johanna Margareta, Konge, Lars, Lehnert, Per, Krogh, Charlotte Loumann, Hansen, Henrik Jessen, Petersen, René Horsleben, and Ringsted, Charlotte
- Published
- 2013
167. Regional analgesia for video-assisted thoracic surgery: a systematic review
- Author
-
Steinthorsdottir, Kristin Julia, primary, Wildgaard, Lorna, additional, Hansen, Henrik Jessen, additional, Petersen, René Horsleben, additional, and Wildgaard, Kim, additional
- Published
- 2013
- Full Text
- View/download PDF
168. No extensive experience in open procedures is needed to learn lobectomy by video-assisted thoracic surgery
- Author
-
Konge, Lars, Petersen, René Horsleben, Hansen, Henrik Jessen, Ringsted, Charlotte, Konge, Lars, Petersen, René Horsleben, Hansen, Henrik Jessen, and Ringsted, Charlotte
- Abstract
Lobectomies done by video-assisted thoracic surgery (VATS) result in fewer complications and less pain and save total costs compared with the traditional approach. However, the majority of procedures are still performed via open thoracotomies, because VATS lobectomy is considered difficult to learn, requiring experience in open surgery, and causing complications in the initial phase of the learning curve. The aim of this study was to describe a training model appreciating patient safety during training and to explore the initial learning curve for a trainee rather inexperienced in open surgery.
- Published
- 2012
169. International Association for the Study of Lung Cancer Computed Tomography Screening Workshop 2011 report
- Author
-
Petersen, René Horsleben and Petersen, René Horsleben
- Abstract
The International Association for the Study of Lung Cancer (IASLC) Board of Directors convened a computed tomography (CT) Screening Task Force to develop an IASLC position statement, after the National Cancer Institute press statement from the National Lung Screening Trial showed that lung cancer deaths fell by 20%. The Task Force's Position Statement outlined a number of the major opportunities to further improve the CT screening in lung cancer approach, based on experience with cancer screening from other organ sites.The IASLC CT Screening Workshop 2011 further developed these discussions, which are summarized in this report. The recommendation from the workshop, and supported by the IASLC Board of Directors, was to set up the Strategic CT Screening Advisory Committee (IASLC-SSAC). The Strategic CT Screening Advisory Committee is currently engaging professional societies and organizations who are stakeholders in lung cancer CT screening implementation across the globe, to focus on delivering guidelines and recommendations in six specific areas: (i) identification of high-risk individuals for lung cancer CT screening programs; (ii) develop radiological guidelines for use in developing national screening programs; (iii) develop guidelines for the clinical work-up of "indeterminate nodules" resulting from CT screening programmers; (iv) guidelines for pathology reporting of nodules from lung cancer CT screening programs; (v) recommendations for surgical and therapeutic interventions of suspicious nodules identified through lung cancer CT screening programs; and (vi) integration of smoking cessation practices into future national lung cancer CT screening programs.
- Published
- 2012
170. International Association for the Study of Lung Cancer Computed Tomography Screening Workshop 2011 Report
- Author
-
Field, John K., Smith, Robert A., Aberle, Denise R., Oudkerk, Matthijs, Baldwin, David R., Yankelevitz, David, Pedersen, Jesper Holst, Swanson, Scott James, Travis, William D., Wisbuba, Ignacio I., Noguchi, Masayuki, Mulshine, Jim L., Petersen, René Horsleben, Field, John K., Smith, Robert A., Aberle, Denise R., Oudkerk, Matthijs, Baldwin, David R., Yankelevitz, David, Pedersen, Jesper Holst, Swanson, Scott James, Travis, William D., Wisbuba, Ignacio I., Noguchi, Masayuki, Mulshine, Jim L., and Petersen, René Horsleben
- Published
- 2012
171. Learning thoracoscopic lobectomy☆☆☆
- Author
-
Petersen, René Horsleben, Hansen, Henrik Jessen, Petersen, René Horsleben, and Hansen, Henrik Jessen
- Published
- 2010
172. Intratorakal struma med differentialdiagnostiske vanskeligheder
- Author
-
Scherer, Susanne, Abd-Elrahmane, Dunia Gazi, Petersen, René Horsleben, Bjarnason, Nina Hannover, Scherer, Susanne, Abd-Elrahmane, Dunia Gazi, Petersen, René Horsleben, and Bjarnason, Nina Hannover
- Abstract
Intrathoracic goiter represents an important differential diagnosis in the examination of lung tumours. A 71-year-old healthy woman presented with dyspnoea, stridor and an inhomogeneous tumour compressing the upper part of the right lung at the level of the left atrium. Computed tomography showed bilateral pleural effusions and a pericardial effusion. Thyroid scintigraphy demonstrated no uptake in the pulmonary mass and material from two sets of core-needle biopsies were inconclusive. Surgery with histology revealed a degenerated benign intrathoracic goiter. Udgivelsesdato: 2009-Jan-12
- Published
- 2009
173. Simulation-Based Training for Thoracoscopy
- Author
-
Bjurström, Johanna Margareta, primary, Konge, Lars, additional, Lehnert, Per, additional, Krogh, Charlotte Loumann, additional, Hansen, Henrik Jessen, additional, Petersen, René Horsleben, additional, and Ringsted, Charlotte, additional
- Published
- 2013
- Full Text
- View/download PDF
174. F-044MINIMIZING AIR LEAK AFTER VIDEO-ASSISTED THORACOSCOPIC LOBECTOMY
- Author
-
Petersen, René Horsleben, primary and Hansen, H.J., additional
- Published
- 2013
- Full Text
- View/download PDF
175. P-139VIDEO ASSISTED THORACOSCOPIC LOBECTOMY: THE COPENHAGEN EXPERIENCE WITH 1165 CASES
- Author
-
Petersen, René Horsleben, primary and Hansen, H.J., additional
- Published
- 2013
- Full Text
- View/download PDF
176. Spontan haemothorax fra en fibrøs pleural tumor hos en vordende far. Er fødestuer farlige for maend?
- Author
-
Kristensen, Peter Lommer, Petersen, René Horsleben, Hansen, Per Boye, Kristensen, Peter Lommer, Petersen, René Horsleben, and Hansen, Per Boye
- Abstract
A 34-year-old male was admitted to our department with dyspnoea and severe pain in the left hemithorax. The symptoms had started suddenly three days before in the delivery room when his child was being born. An X-ray of the chest showed a tumour in the left side of the mediastinum and a large left pleural effusion. This was confirmed by CT, which revealed a round mass 11 cm in diameter. During the operation a benign solitary fibrous tumour was radically resected from the pleura and a large hemothorax was removed. This unusual presentation with severe bleeding from a pleural tumour was most probably initiated by the expectant father's excitement during his wife's labour.
- Published
- 2007
177. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy.
- Author
-
Laursen, Lykke Østergaard, Petersen, René Horsleben, Hansen, Henrik Jessen, Jensen, Tina Kold, Ravn, Jesper, and Konge, Lars
- Subjects
- *
VIDEO-assisted thoracic surgery , *LOBECTOMY (Lung surgery) , *LUNG cancer treatment , *THORACOTOMY , *ETIOLOGY of diseases , *DATABASES - Abstract
OBJECTIVES: Lung cancer is the most common cause of cancer-related deaths worldwide. Survival is highly dependent on surgery. Videoassisted thoracoscopic surgery (VATS) is increasingly chosen over open thoracotomy (OT) because of the possible benefits of the minimally invasive approach. Consequently, our aim was to compare the 30-day morbidity and mortality for lung cancer patients operated by VATS lobectomy or lobectomy by OT. METHOD: Data were obtained from prospective national and regional databases, including patients who underwent lobectomy for lung cancer in the eastern part of Denmark from 1 January 2005 to 31 December 2011. All patients operated before 2009 were re-staged according to the latest International Association for the Study of Lung Cancer lung cancer classification. Patient characteristics, comorbidities, pathology and operative data were assessed using an independent samples t-test, Pearson's ?2, Fisher's exact test and Mann-Whitney test. Morbidity was assessed using multinomial logistic regression adjusted for gender, age, cancer stage, forced expiratory volume in 1 s (FEV1), year of surgery and Charlson comorbidity score. RESULTS: In total, 1379 patients underwent lobectomy, 785 patients via VATS and 594 patients via thoracotomy. The two groups were similar in gender and FEV1. The patients operated by VATS were older (P < 0.001), and had a lower Charlson comorbidity score (P = 0.034), higher frequency of adenocarcinomas (P < 0.001) and lower cancer stage (P < 0.001). Among the VATS patients, 285 (36.3%) and among the thoracotomy patients, 288 (48.5%) had minor complications (P < 0.001); and 157 (20.0%) VATS patients and 212 (35.7%) thoracotomy patients had major complications (P < 0.001). The 30-day mortality rate was 1% in the VATS group and 1.5% in the thoracotomy group (P = 0.47). Multinomial logistic regression analysis showed that the prevalence of both minor [odds ratio (OR) = 1.51; 95% confidence interval (Cl) = 1.18-1.96] and major complications (OR = 1.91, 95% Cl = 1.44-2.53) was significantly higher for patients who underwent lobectomy via thoracotomy compared with VATS. CONCLUSION: Patients undergoing lobectomy via VATS were less likely to have at least one minor complication within the first 30 postoperative days and less likely to have at least one major complication, compared with patients operated by thoracotomy. These findings remained after adjusting for gender, age, FEV1, cancer stage, year of surgery and Charlson comorbidity score. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
178. Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database.
- Author
-
Falcoz, Pierre-Emmanuel, Puyraveau, Marc, Thomas, Pascal-Alexandre, Decaluwe, Herbert, Hürtgen, Martin, Petersen, René Horsleben, Hansen, Henrik, and Brunelli, Alessandro
- Subjects
CANCER treatment ,NON-small-cell lung carcinoma ,LOBECTOMY (Lung surgery) ,VIDEO-assisted thoracic surgery ,CHEST endoscopic surgery ,MEDICAL databases ,MORTALITY - Abstract
OBJECTIVES: Video-assisted thoracoscopic anatomical resections are increasingly used in Europe to manage primary lung cancer. The purpose of this study was to compare the outcome following thoracoscopic versus open lobectomy in case-matched groups of patients from the European Society of Thoracic Surgeon (ESTS) database. METHODS: All patients having lobectomy as the primary procedure via thoracoscopy [video-assisted thoracoscopic surgery (VATS)-L)] or thoracotomy (TH-L) were identified in the ESTS database ( January 2007 to December 2013). A propensity score was constructed using several patients’ baseline characteristics. The matching using the propensity score was responsible for the minimization of selection bias. A propensity score-matched analysis was performed to compare the incidence of postoperative major complications (according to the ESTS database definitions) and mortality at hospital discharge between the matched groups. After exclusions, 28 771 patients were identified: 26 050 having thoracotomy and 2721 having thoracoscopy. Propensity score yielded two well-matched groups of 2721 patients. Numeric variables were compared by Student’s t-tests and categorical variables were compared by McNemar’s tests. RESULTS: Compared with TH-L, VATS-L was associated with a lower incidence of total complications [n = 792 (29.1%) vs 863 (31.7%), P = 0.0357], major cardiopulmonary complications [n = 316 (15.9%) vs 435 (19.6%), P = 0.0094], atelectasis requiring bronchoscopy [n = 65 (2.4%) vs 150 (5.5%), P < 0.0001], initial ventilation >48 h [n = 18 (0.7%) vs 38 (1.4%), P = 0.0075] and wound infection [n = 6 (0.2%) vs 17 (0.6%), P = 0.0218]. There was no difference in the incidence of postoperative atrial fibrillation between the two groups (P = 0.14). Postoperative hospital stay was 2 days shorter in the VATS-L patients (mean: 7.8 vs 9.8 days; P = 0.0003). In terms of outcome at hospital discharge, there were 27 deaths in the VATS-L group (1%) versus 50 in the TH-L group (1.9%, P = 0.0201). CONCLUSIONS: Data from the ESTS database confirmed that lobectomy performed through VATS is associated with a lower incidence of complications compared with thoracotomy. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
179. Diagnosis and treatment of bronchopulmonary neuroendocrine tumours: State of the art.
- Author
-
Tabaksblat, Elizaveta Mitkina, Ladekarl, Morten, Langer, Seppo W., Knigge, Ulrich, Grønbæk, Henning, Mortensen, Jann, Petersen, René Horsleben, and Federspiel, Birgitte Hartnack
- Subjects
TREATMENT of lung tumors ,DIFFERENTIAL diagnosis ,BRONCHIAL tumors ,LUNG tumors ,NEUROENDOCRINE tumors ,ONCOLOGY ,TUMOR markers ,DISEASE management ,DIAGNOSIS ,TUMOR treatment - Abstract
Bronchopulmonary neuroendocrine tumours (BP-NET) are a heterogeneous population of neoplasms with different pathology, clinical behaviour and prognosis compared to the more common lung cancers. The management of BP-NET patients is largely based on studies with a low level of evidence and extrapolation of data obtained from more common types of neuroendocrine tumours. This review reflects our view of the current state of the art of diagnosis and treatment of patients with BP-NET. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
- Full Text
- View/download PDF
180. Is complex segmentectomy safe?
- Author
-
Petersen, René Horsleben
- Subjects
- *
EARLY detection of cancer , *LUNG cancer - Published
- 2022
- Full Text
- View/download PDF
181. Reliable and valid assessment of performance in thoracoscopy
- Author
-
Konge, Lars, primary, Lehnert, Per, additional, Hansen, Henrik Jessen, additional, Petersen, René Horsleben, additional, and Ringsted, Charlotte, additional
- Published
- 2011
- Full Text
- View/download PDF
182. Video-assisted thoracoscopic surgery (VATS) lobectomy using a standardized anterior approach
- Author
-
Hansen, Henrik Jessen, primary, Petersen, René Horsleben, additional, and Christensen, Merete, additional
- Published
- 2010
- Full Text
- View/download PDF
183. Learning thoracoscopic lobectomy☆☆☆
- Author
-
Petersen, René Horsleben, primary and Hansen, Henrik Jessen, additional
- Published
- 2010
- Full Text
- View/download PDF
184. Hospital stay after video-assisted thoracoscopic surgery.
- Author
-
Kehlet, Henrik, Huang, Lin, and Petersen, René Horsleben
- Subjects
VIDEO-assisted thoracic surgery ,ENHANCED recovery after surgery protocol ,LOBECTOMY (Lung surgery) ,HOSPITALS - Abstract
I Dear Editor i We would like to thank Shen I et al. i for their interest in our study[1] and their comments on our results. Reasons for staying in hospital after video-assisted thoracoscopic surgery lobectomy. Although reduction of length of hospital stay is one of the goals of enhanced recovery after surgery (ERAS), focus should be on faster achievement of accepted discharge criteria rather than the length itself. [Extracted from the article]
- Published
- 2022
- Full Text
- View/download PDF
185. Regional analgesia for video-assisted thoracic surgery: a systematic review.
- Author
-
Steinthorsdottir, Kristin Julia, Wildgaard, Lorna, Hansen, Henrik Jessen, Petersen, René Horsleben, and Wildgaard, Kim
- Subjects
THORACIC surgery ,SYSTEMATIC reviews ,PARAVERTEBRAL anesthesia ,ANALGESICS ,EPIDURAL anesthesia ,NERVE block ,PAIN management ,LUNG cancer treatment ,THERAPEUTICS - Abstract
Video-assisted thoracic surgery (VATS) is emerging as the standard surgical procedure for both minor and major oncological lung surgery. Thoracic epidural analgesia (TEA) and paravertebral block (PVB) are established analgesic golden standards for open surgery such as thoracotomy; however, there is no gold standard for regional analgesia for VATS. This systematic review aimed to assess different regional techniques with regard to effect on acute postoperative pain following VATS, with emphasis on VATS lobectomy. The systematic review of PubMed, The Cochrane Library and Embase databases yielded 1542 unique abstracts; 17 articles were included for qualitative assessment, of which three were studies on VATS lobectomy. The analgesic techniques included TEA, multilevel and single PVB, paravertebral catheter, intercostal catheter, interpleural infusion and long thoracic nerve block. Overall, the studies were heterogeneous with small numbers of participants. In comparative studies, TEA and especially PVB showed some effect on pain scores, but were often compared with an inferior analgesic treatment. Other techniques showed no unequivocal results. No clear gold standard for regional analgesia for VATS could be demonstrated, but a guide of factors to include in future studies on regional analgesia for VATS is presented. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
186. Guidelines for enhanced recovery after lung surgery: need for re-analysis.
- Author
-
Petersen, René Horsleben, Huang, Lin, and Kehlet, Henrik
- Subjects
- *
LUNG surgery , *LOBECTOMY (Lung surgery) - Abstract
ERAS, Lung surgery, VATS lobectomy, Fast track. [Extracted from the article]
- Published
- 2021
- Full Text
- View/download PDF
187. Erroneous transection of bronchovascular structures during video-assisted thoracoscopic anatomical lung resections: is there a critical view of safety?
- Author
-
Li, Wilson W. L., Verhagen, Ad F. T. M., Decaluwe, Herbert, Petersen, René Horsleben, Hansen, Henrik, and Gossot, Dominique
- Subjects
SURGICAL complications ,SURGICAL excision - Abstract
Letter to the editor are presented in response to article "Major intraoperative complications during video-assisted thoracoscopic anatomical lung resections: an intention-to-treat analysis" by H. Decaluwe and colleagues in the previous issue along with response from the authors.
- Published
- 2016
- Full Text
- View/download PDF
188. Recurrence Rates and Patterns after Radical Resection of Lung Carcinoids.
- Author
-
Askildsen, Erika, Soldath, Patrick, Langer, Seppo W., Andreassen, Mikkel, Knigge, Ulrich, and Petersen, René Horsleben
- Subjects
- *
CARCINOID , *CANCER relapse , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *LUNG tumors , *CONFIDENCE intervals , *PROPORTIONAL hazards models , *PATIENT aftercare - Abstract
Simple Summary: Lung carcinoids are known to be less malignant than other types of lung cancers. However, atypical lung carcinoids are more prone to recur after radical surgery than typical lung carcinoids. The aim of our retrospective study was to assess the rate of recurrence of low-stage atypical and typical carcinoids when accounting for competing events. We confirmed that atypical carcinoids recurred more often than typical carcinoids within 5 and 10 years after radical surgery. Atypical carcinoids at a low stage are more prone to recur after radical surgery, suggesting that all patients operated for atypical carcinoid should undergo close follow-up care after surgery. Atypical lung carcinoid (AC) is widely accepted to recur more often after radical resection than typical lung carcinoid (TC). However, their recurrence rates have never been compared in a multi-state competing risks model. We retrospectively reviewed files from patients with AC and TC who had been radically resected at our European Neuroendocrine Tumor Society Center of Excellence between 2009 and 2020. We estimated the recurrence rates between the AC and TC patients counting unrelated death as a competing event using Aalen–Johansen estimates and compared them using a multi-state Cox model. Finally, we analyzed all AC and TC recurrences as to resection type, pathological stage, resection margin, recurrence site, and time to recurrence. The study included 217 patients, of whom 194 had TC and 23 had AC. The median follow-up was 9.4 years. The AC patients experienced recurrence at a higher rate (hazard ratio [HR] 16.0, 95% confidence interval [CI] 5.3–47.9, p < 0.001). Correspondingly, the 5- and 10-year recurrence rates were 18% and 32% for AC and merely 1.0% and 2.4% for TC. In patients without nodal involvement, AC recurred at a considerably higher rate (HR 41.2, 95% CI 8.7–194.8, p < 0.001) than TC. In both AC and TC, most recurrences were distant and occurred in patients with a resection margin less than 2 cm. We conclude that AC recurs more often than TC, even in patients without nodal involvement at surgery, suggesting that all AC patients regardless of their pathological stage should undergo close follow-up care after surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
189. Long-term outcomes after video-assisted thoracoscopic surgery in pulmonary large-cell neuroendocrine carcinoma
- Author
-
Soldath, Patrick, Binderup, Tina, Carstensen, Frederik, Clausen, Malene Martini, Kjaer, Andreas, Federspiel, Birgitte, Knigge, Ulrich, Langer, Seppo W., and Petersen, René Horsleben
- Abstract
Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare subtype of lung cancer with dismal prognosis. Long-term outcomes after primarily video-assisted thoracoscopic surgery (VATS) have not yet been described in LCNEC. This study aims to determine overall survival and recurrence-free survival after VATS as well as to identify prognostic factors for survival and recurrence.
- Published
- 2022
- Full Text
- View/download PDF
190. Effect of posture on pulmonary function and oxygenation after fast-tracking video-assisted thoracoscopic surgery (VATS) lobectomy: a prospective pilot study.
- Author
-
Huang, Lin, Kehlet, Henrik, and Petersen, René Horsleben
- Subjects
- *
VIDEO-assisted thoracic surgery , *OXYGEN in the blood , *OXYGEN saturation , *MINIMALLY invasive procedures , *FORCED expiratory volume , *CHEST tubes , *TEMPORAL lobectomy - Abstract
Background: Minimally invasive surgery combined with enhanced recovery programmes has improved outcomes after lung cancer surgery and where early mobilisation may be an important factor. However, little is known about pulmonary function and oxygenation during mobilisation after video-assisted pulmonary lobectomy. The aim of this prospective pilot cohort study was to explore the effect of postural changes (from supine to sitting to standing) on pulmonary function and oxygen saturation in a well-defined enhanced recovery programmes setting after video-assisted thoracoscopic surgery lobectomy. Methods: A total of 24 patients were evaluated daily for postoperative pain score, pulmonary function (forced expiratory volume 1 s) and oxygen saturation in supine, sitting and standing position from 6 h after surgery to 6 h after chest drain removal. Results: Mobilisation from supine to standing position showed a significant 7.9% increase (p = 0.04) in forced expiratory volume in 1 s percentage and oxygen saturation about 1.8% (p< 0.001) without increasing pain (p = 0.809). Conclusions: Early mobilisation should be encouraged to enhance recovery after video-assisted thoracoscopic surgery lobectomy by increasing lung function and oxygen delivery. Trial registration: • Name of the registry: clinicaltrials.gov • Trial registration number: NCT04508270 • Date of registration: August 11, 2020 [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
191. Predictors of reoperation after lung volume reduction surgery.
- Author
-
Lund, Alberte, Soldath, Patrick, Nodin, Erika, Hansen, Henrik Jessen, Perch, Michael, Jensen, Kristine, Hornbech, Kåre, Kalhauge, Anna, Mortensen, Jann, and Petersen, René Horsleben
- Subjects
- *
REOPERATION , *LUNG volume , *LUNG surgery - Abstract
Objectives: Lung volume reduction surgery (LVRS) has proven an effective treatment for emphysema, by decreasing hyperinflation and improving lung function, activity level and reducing dyspnoea. However, postoperative air leak is an important complication, often leading to reoperation. Our aim was to analyse reoperations after LVRS and identify potential predictors. Methods: Consecutive single-centre unilateral VATS LVRS performed from 2017 to 2022 were included. Typically, 3–5 minor resections were made using vascular magazines without buttressing. Data were obtained from an institutional database and analysed. Multivariable logistic regression was used to identify predictors of reoperation. Number and location of injuries were registered. Results: In total, 191 patients were included, 25 were reoperated (13%). In 21 patients, the indication for reoperation was substantial air leak, 3 patients bleeding and 1 patient empyema. Length of stay (LOS) was 21 (11–33) vs. 5 days (3–11), respectively. Only 3 injuries were in the stapler line, 13 within < 2cm and 15 injuries were in another site. Multivariable logistic regression analysis showed that decreasing DLCO increased risk of reoperation, OR 1.1 (1.03, 1.18, P = 0.005). Resections in only one lobe, compared to resections in multiple lobes, were also a risk factor OR 3.10 (1.17, 9.32, P = 0.03). Patients undergoing reoperation had significantly increased 30-day mortality, OR 5.52 (1.03, 26.69, P = 0.02). Conclusions: Our incidence of reoperation after LVRS was 13% leading to prolonged LOS and increased 30-day mortality. Low DLCO and resections in a single lobe were significant predictors of reoperation. The air leak was usually not localized in the stapler line. Key question: What characterizes reoperations after lung volume reduction surgeries? Key findings: Lung injuries were predominantly located away from the original surgical site. Take home message: Lung injuries remote from the stapler line is frequent during reoperation after lung volume reduction surgery. Location of lung injuries found during reoperation after lung volume reduction surgery [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
192. Prognostic Thresholds of Mitotic Count and Ki-67 Labeling Index for Recurrence and Survival in Lung Atypical Carcinoids.
- Author
-
Soldath, Patrick, Bianchi, Daniel, Manfredini, Beatrice, Kjaer, Andreas, Langer, Seppo W., Knigge, Ulrich, Melfi, Franca, Filosso, Pier Luigi, and Petersen, René Horsleben
- Subjects
- *
STAINS & staining (Microscopy) , *LUNG tumors , *DISEASE incidence , *RETROSPECTIVE studies , *CELL physiology , *COMPARATIVE studies , *CARCINOID , *CYTOGENETICS , *TUMOR markers , *RECEIVER operating characteristic curves , *PROPORTIONAL hazards models - Abstract
Simple Summary: Atypical carcinoid is a rare type of lung cancer, which exhibits a varying malignant potential. In this study, we aimed to identify the prognostic thresholds of the mitotic count and Ki-67 labeling index for recurrence and survival in atypical carcinoids. Our findings show that more patients recurred and died from this disease if their mitotic count exceeded three and four mitoses per 2 mm2, respectively, or if their Ki-67 labeling index exceeded 14% and 11%, respectively. These thresholds may serve as a valuable tool for clinicians and researchers in making treatment plans and predicting outcomes for patients with atypical carcinoids. Atypical carcinoid (AC) is a rare neuroendocrine neoplasm of the lung, which exhibits a varying malignant potential. In this study, we aimed to identify the prognostic thresholds of the mitotic count and Ki-67 labeling index for recurrence and survival in AC. We retrospectively reviewed 78 patients who had been radically resected for AC and calculated said thresholds using time-dependent receiver operating characteristic curves and the Youden index. We then dichotomized the patients into groups of above or below these thresholds and estimated the cumulative incidences of the groups using the Aalen–Johansen estimator. We compared the groups using univariable and multivariable Fine–Gray subdistribution hazard models. Our findings show that more patients recurred and died from this disease if their mitotic count exceeded three and four mitoses per 2 mm2, respectively, or if their Ki-67 labeling index exceeded 14% and 11%, respectively. Both thresholds independently predicted survival (p < 0.001 and p = 0.015, respectively). These thresholds may serve as a valuable tool for clinicians and researchers in making treatment plans and predicting outcomes for patients with AC. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
193. Ready to Go Home? Nurses’ Perspectives of Prolonged Admission for Patients Undergoing Video-Assisted Thoracic Surgery for Non-Small-Cell Lung Cancer in Denmark.
- Author
-
Missel, Malene, Donsel, Pernille Orloff, Petersen, René Horsleben, and Beck, Malene
- Abstract
Enhanced recovery after surgery programs with median postoperative hospitalization of 2 days improve outcomes after lung cancer surgery. This article explores nursing care practices for patients with lung cancer who remain hospitalized despite having recovered somatically. Qualitative focus group interviews were conducted with 16 nurses. Ricoeur’s phenomenological hermeneutics underpins the methodology applied in this study, and we relied on Benner and Wrubel’s theory. The nurses emphasized that the thoughts of patients with a recent lung cancer diagnosis revolve around more than the surgery. Nursing comprises not only practicalities but also attending to patients’ stress and their coping with being struck with lung cancer and having undergone surgery. A counterculture emerged to counteract the logic of productivity, indicating that caring as a worthy end in itself may be underestimated in protocol-driven care. Prolonging hospitalization largely depends on clinical judgment. The nurses’ aim is not to keep patients in the hospital but to avoid any needless suffering, allowing them to reclaim the primacy of caring. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
194. Evaluating competency in video-assisted thoracoscopic surgery (VATS) lobectomy performance using a novel assessment tool and virtual reality simulation.
- Author
-
Jensen, Katrine, Hansen, Henrik Jessen, Petersen, René Horsleben, Neckelmann, Kirsten, Vad, Henrik, Møller, Lars Borgbjerg, Pedersen, Jesper Holst, and Konge, Lars
- Subjects
- *
CHEST endoscopic surgery , *LOBECTOMY (Lung surgery) , *VIDEOS , *INTRACLASS correlation , *TEST reliability , *RESEARCH , *THORACIC surgery , *MEDICAL students , *RESEARCH methodology , *EVALUATION research , *MEDICAL cooperation , *COMPARATIVE studies , *CLINICAL competence , *PNEUMONECTOMY ,RESEARCH evaluation - Abstract
Background: Competency-based training has gained ground in surgical training and with it assessment tools to ensure that training objectives are met. Very few assessment tools are available for evaluating performance in thoracoscopic procedures. Video recordings would provide the possibility of blinded assessment and limited rater bias. This study aimed to provide validity evidence for a newly developed and dedicated tool for assessing competency in Video-Assisted Thoracoscopic Surgery (VATS) lobectomy.Methods: Participants with varying experience with VATS lobectomy were included from different countries. Video recordings from participants' performance of a VATS right upper lobe lobectomy on a virtual reality simulator were rated by three raters using a modified version of a newly developed VATS lobectomy assessment tool (the VATSAT) and analyzed in relation to the unitary framework (content, response process, internal structure, relation to other variables, and consequences of testing).Results: Fifty-three participants performed two consecutive simulated VATS lobectomies on the virtual reality simulator, leaving a total of 106 videos. Content established in previously published studies. Response process Standardized data collection was ensured by using an instructional element, uniform data collection, a special rating program, and automatic generation of the results to a database. Raters were carefully instructed in using the VATSAT, and tryout ratings were carried out. Internal structure Inter-rater reliability was calculated as intra-class correlation coefficients, to 0.91 for average measures (p < 0.001). Test/re-test reliability was calculated as Pearson's r of 0.70 (p < 0.001). G-coefficient was calculated to be 0.79 with two procedures and three raters. By performing D-theory was found that either three procedures rated by two raters or five procedures rated by one rater were enough to reach an acceptable G-coefficient of ≥ 0.8. Relation to other variables Significant differences between groups were found (p < 0.001). The participants' VATS lobectomy experience correlated significantly to their VATSAT score (p = 0.016). Consequences of testing The pass/fail score was found to be 14.9 points by the contrasting groups' method, leaving five false positive (29%) and six false negatives (43%).Conclusion: Validity evidence was provided for the VATSAT according to the unitary framework. The VATSAT provides supervisors and assessors with a procedure-specific assessment tool for evaluating VATS lobectomy performance and aids with the decision of when the trainee is ready for unsupervised performance. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
195. Do enhanced recovery after lung cancer surgery programs risk putting primacy of caring at stake? A qualitative focus group study on nurses' perspectives.
- Author
-
Missel, Malene, Beck, Malene, Donsel, Pernille Orloff, Petersen, René Horsleben, and Benner, Patricia
- Subjects
- *
OCCUPATIONAL roles , *NURSES' attitudes , *NURSING , *FOCUS groups , *THORACIC surgery , *LUNG tumors , *NURSING theory , *QUALITATIVE research , *PHENOMENOLOGY , *NURSES , *PROFESSIONAL identity , *RESEARCH funding , *ENHANCED recovery after surgery protocol - Abstract
Aims and Objectives: To gain insight into nursing in an enhanced recovery after surgery program for lung cancer, we explored its meaning for nurses in a thoracic surgery unit. Background: Since nurses play a key role in overcoming implementation barriers in enhanced recovery after surgery programs, successful implementation depends on their care approach during the surgery pathway. Design: Qualitative focus group study. Methods: A hermeneutic approach inspired by Gadamer guided the research. Sixteen thoracic surgery nurses participated in focus group interviews. Benner and Wrubel's primacy of caring theory enhanced understanding of the findings. COREQ guidelines were followed. Results: The thoracic surgery nurses compared the streamlined trajectory in the program to working in a factory. Shifting focus away from a dialogue‐based, situated care practice compromised their professional nursing identity. The program made combining scientific evidence with patients' lifeworld perspectives challenging. Although the nurses recognised that the physiological processes and positive outcomes promoted recovery, they felt each patient's life situation was not sufficiently considered. To meet the program's professional nursing responsibilities and provide comprehensive care, specialised thoracic nursing should continue after discharge to allow professional care while meaningfully engaging with the patient's situatedness and lifeworld. Conclusions: Primacy of caring risks being compromised if accelerated treatment is implemented uncritically. If care is based on the dominant rational justifications underpinning surgical nursing, living conditions and patient values might be overlooked, affecting how disease, illness and health are managed. Relevance to Clinical Practice: Our findings focus on obvious unintended consequences of enhanced recovery after surgery programs. To avoid dehumanising patients, surgical lung cancer programs must adopt a humanistic attitude in a caring practice guided by the moral art and ethics of care and responsibility. Public Contribution: To reminding us of what matters and helping us think differently, we discussed the results of the study with organisational stakeholders. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
196. Assessing VATS competence based on simulated lobectomies of all five lung lobes.
- Author
-
Haidari, Tamim Ahmad, Bjerrum, Flemming, Christensen, Thomas Decker, Vad, Henrik, Møller, Lars Borgbjerg, Hansen, Henrik Jessen, Konge, Lars, and Petersen, René Horsleben
- Abstract
Objectives: To determine the number of procedures and expert raters necessary to provide a reliable assessment of competence in Video-Assisted Thoracoscopic Surgery (VATS) lobectomy. Methods: Three randomly selected VATS lobectomies were performed on a virtual reality simulator by participants with varying experience in VATS. Video recordings of the procedures were independently rated by three blinded VATS experts using a modified VATS lobectomy assessment tool (VATSAT). The unitary framework of validity was used to describe validity evidence, and generalizability theory was used to explore the reliability of different assessment options. Results: Forty-one participants (22 novices, 10 intermediates, and 9 experienced) performed a total of 123 lobectomies. Internal consistency reliability, inter-rater reliability, and test–retest reliability were 0.94, 0.85, and 0.90, respectively. Generalizability theory found that a minimum of two procedures and four raters or three procedures and three raters were needed to ensure the overall reliability of 0.8. ANOVA showed significant differences in test scores between the three groups (P < 0.001). A pass/fail level of 19 out of 25 points was established using the contrasting groups' standard setting method, leaving one false positive (one novice passed) and zero false negatives (all experienced passed). Conclusion: We demonstrated validity evidence for a VR simulator test with different lung lobes, and a credible pass/fail level was identified. Our results can be used to implement a standardized mastery learning training program for trainees in VATS lobectomies that ensures that everyone reaches basic competency before performing supervised operations on patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
197. Early and late readmissions after enhanced recovery thoracoscopic lobectomy.
- Author
-
Huang, Lin, Frandsen, Mikkel Nicklas, Kehlet, Henrik, and Petersen, René Horsleben
- Subjects
- *
LOBECTOMY (Lung surgery) , *PATIENT readmissions , *VIDEO-assisted thoracic surgery , *CHRONIC obstructive pulmonary disease - Abstract
Open in new tab Download slide OBJECTIVES The purpose of this study was to describe the incidence of and reasons for early (0–30 days) and late (31–90 days) readmissions after enhanced recovery video-assisted thoracoscopic surgery lobectomy. METHODS We performed a retrospective analysis of prospectively collected consecutive VATS lobectomy data in an institutional database from January 2019 through December 2020. All reasons for readmission with complete follow-up were individually evaluated. Univariable and multivariable analyses were used to assess predictors. RESULTS In total, 508 patients were included; the median length of stay after the operation was 3 days. There were 77 (15%) early and 54 (11%) late readmissions, respectively. There were 33 (7%) multiple readmissions during postoperative days 0–90 ; pneumonia (19.8%) and pneumothorax (18.3%) were the dominant reasons for early readmissions, and the side effects of adjuvant chemotherapy (22.0%), for late readmissions. In multivariable analyses, current smoking (P = 0.001), alcohol abuse (P = 0.024) and chronic obstructive pulmonary disease (P = 0.019) were predictors of early readmissions, whereas Clavien-Dindo I-II grade gastrointestinal complications predicted late readmissions (P = 0.006) and multiple readmissions (P = 0.007). Early discharge (< 3 days) was not a predictor of readmissions. Early readmission did not increase late readmission. CONCLUSIONS Early and late readmissions after video-assisted thoracoscopic lobectomy are frequent even when enhanced recovery programmes are followed. Pulmonary complications and adjuvant chemotherapy are the most predominant reasons for early and late readmissions. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
198. Days alive and out of hospital after enhanced recovery video-assisted thoracoscopic surgery lobectomy.
- Author
-
Huang, Lin, Frandsen, Mikkel Nicklas, Kehlet, Henrik, and Petersen, René Horsleben
- Subjects
- *
VIDEO-assisted thoracic surgery , *ENHANCED recovery after surgery protocol , *LOBECTOMY (Lung surgery) , *NON-small-cell lung carcinoma , *ADJUVANT chemotherapy , *CARBON monoxide - Abstract
Open in new tab Download slide OBJECTIVES Days alive and out of hospital (DAOH) integrates overall information of hospitalization, readmissions, and mortality that have been applied as a new outcome measure. However, DAOH after video-assisted thoracoscopic surgery (VATS) in an established enhanced recovery after surgery (ERAS) programme has not been reported. METHODS Patients aged ≥18 years with non-small-cell lung cancer undergoing VATS lobectomy in an established ERAS programme were eligible. The primary and secondary outcomes were DAOH during the first postoperative 365 days and reasons for reduced DAOH. RESULTS A total of 316 consecutive patients with well-defined inclusion criteria and complete follow-up were assessed retrospectively. The median length of stay was 3 days (IQR 2–6). The medians (IQR) of postoperative 30, 60, 90, 180 and 365 DAOH were 27 (22–28), 57 (51–58), 86 (80–88), 176 (169–178) and 359 (349–363) days, respectively. Air leak was the dominant factor for reduced DAOH from postoperative day (POD) 0–30 (47.2%) and 0–365 (38.3%). Side effects of adjuvant chemotherapy were dominant from POD 31–60 and 61–90 (23.5% and 47.1%) and recurrence/metastases from POD 91–180 and 181–365 (25.6% and 50.0%). A low diffusing capacity for carbon monoxide (odds ratios 1.28, 95% confidence interval 1.07–1.53; P =0.007) and prior surgical history (odds ratios 1.80, 95% confidence interval 1.08–2.99; P =0.023) were predictors for low DAOH. CONCLUSIONS DAOH after 1 year with an established VATS lobectomy ERAS programme was only reduced with a median of 6 days. The main factors reducing DAOH were air leak, adjuvant chemotherapy and recurrence. DAOH may be an important patient-centred outcome to define future improvement strategies. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
199. Did conversion to thoracotomy during thoracoscopic lobectomy increase post‐operative complications and prejudice survival? Results of best evidence topic analysis.
- Author
-
Fiorelli, Alfonso, Forte, Stefano, Santini, Mario, Petersen, René Horsleben, and Fang, Wentao
- Subjects
- *
PERIOPERATIVE care , *TISSUE adhesions , *LENGTH of stay in hospitals , *BLOOD vessels , *SYSTEMATIC reviews , *TIME , *MORTALITY , *THORACOTOMY , *LYMPH nodes , *RISK assessment , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *CALCINOSIS , *SURVIVAL analysis (Biometry) , *THORACOSCOPY , *LUNG surgery , *EVALUATION ,SURGICAL complication risk factors - Abstract
The potential complications related to unplanned conversion to thoracotomy remains a major concern in thoracoscopic lobectomy and may limit the wide adoption of this strategy. We reviewed the literature from 1990 until February 2022, analyzing all papers comparing successful thoracoscopic lobectomy versus converted thoracoscopic lobectomy and/or upfront thoracotomy lobectomy to establish whether unplanned conversion negatively affected outcomes. Thirteen studies provided the most applicable evidence to evaluate this issue. Conversion to thoracotomy was reported to occur in up to 23% of cases (range, 5%–16%). Vascular injury, calcified lymph nodes, and dense adhesions were the most common reasons for conversion. Converted thoracoscopic lobectomy compared to successful thoracoscopic lobectomy was associated with longer operative time and hospital stay in all studies, with higher postoperative complication rates in seven studies, and with higher perioperative mortality rates in four studies. No significant differences were found between converted thoracoscopic lobectomy and upfront thoracotomy lobectomy. Five studies evaluated long‐term survival, and in all papers conversion did not prejudice survival. Surgeons should not fear unplanned conversion during thoracoscopic lobectomy, but to avoid unexpected conversion that may negatively impact surgical outcome, a careful selection of patients is recommended–especially for frail patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
200. Simulation-based VATS resection of the five lung lobes: a technical skills test.
- Author
-
Haidari, Tamim Ahmad, Bjerrum, Flemming, Hansen, Henrik Jessen, Konge, Lars, and Petersen, René Horsleben
- Subjects
- *
VIDEO-assisted thoracic surgery , *LUNGS , *THORACIC surgery , *VIRTUAL reality , *STATISTICAL reliability , *LOBECTOMY (Lung surgery) - Abstract
Background: Video-Assisted Thoracoscopic Surgery (VATS) lobectomy is an advanced procedure and to maximize patient safety it is important to ensure the competency of thoracic surgeons before performing the procedure. The objective of this study was to investigate validity evidence for a virtual reality simulator-based test including multiple lobes of the lungs. Method: VATS experts from the department of Cardiothoracic Surgery at Rigshospitalet, Copenhagen, Denmark, worked with Surgical Science (Gothenburg, Sweden) to develop VATS lobectomy modules for the LapSim® virtual reality simulator covering all five lobes of the lungs. Participants with varying experience in VATS were recruited and classified as either novice, intermediate, or experienced surgeons. Each participant performed VATS lobectomy on the simulator for three different randomly chosen lobes. Nine predefined simulator metrics were automatically recorded on the simulator. Results: Twenty-two novice, ten intermediate, and nine experienced surgeons performed the test resulting in a total of 123 lobectomies. Analysis of Variances (ANOVA) found significant differences between the three groups for parameters: blood loss (p < 0.001), procedure time (p < 0.001), and total instrument path length (p = 0.03). These three metrics demonstrated high internal consistency and significant test–retest reliability was found between each of them. Relevant pass/fail levels were established for each of the three metrics, 541 ml, 30 min, and 71 m, respectively. Conclusion: This study provides validity evidence for a simulator-based test of VATS lobectomy competence including multiple lobes of the lungs. The test can be used to ensure basic competence at the end of a simulation-based training program for thoracic surgery trainees. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.