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Anatomic lung resections for benign pulmonary diseases by video-assisted thoracoscopic surgery (VATS)

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Abstract

Purpose

Based on increasing evidence of its benefits regarding perioperative and oncologic outcome, video-assisted thoracoscopic surgery (VATS) has gained increasing acceptance in the surgical treatment of early stage non-small cell lung cancer (NSCLC). However, the evidence for a VATS approach in anatomic lung resection for benign pulmonary diseases is still limited.

Methods

Between March 2011 and May 2014, data from 33 and 63 patients who received VATS anatomic lung resection for benign diseases (VATS-B) and early stage NSCLC (VATS-N), respectively, were analyzed retrospectively. For subgroup analyses, VATS-B was subdivided by operation time and underlying diseases. Subgroups were compared to VATS-N.

Results

Three patients from VATS-B and four from VATS-N experienced conversion to open surgery. Causes of conversion in VATS-B were intraoperative complications, whereas conversions in VATS-N were elective for oncological concerns (p < 0.05). Operation time and duration of postoperative mechanical ventilation were longer by tendency; postoperative stay on intensive care unit and chest tube duration were significantly longer in VATS-B. Subgroup analyses showed a longer operation time as a predictor for worse perioperative outcome regarding postoperative mechanical ventilation, postoperative stay on intensive care unit, chest tube duration, and length of hospital stay. Patients with longer operation time suffered from more postoperative complications. Differences in perioperative outcome data were not significantly dependent on the underlying benign diseases compared to VATS-N.

Conclusions

VATS is feasible and safe in anatomic lung resection for benign pulmonary diseases. Not the underlying disease, but a longer operation time is a factor for worse postoperative outcome.

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Authors’ contributions

All authors significantly contributed to this manuscript.

Study conception and design: Martin Reichert, Johannes Bodner.

Acquisition of data: Martin Reichert, Julia Bender, Bernd Pösentrup, Emmanuel Schneck.

Analysis and interpretation of data: Martin Reichert, Stefanie Kerber, Winfried Padberg, Johannes Bodner.

Drafting of manuscript: Martin Reichert, Johannes Bodner.

Critical revision of manuscript: Florian Augustin, Dietmar Öfner, Winfried Padberg.

Author information

Authors and Affiliations

  1. Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim Strasse 7, 35392, Giessen, Germany

    Martin Reichert, Stefanie Kerber, Bernd Pösentrup, Julia Bender, Winfried Padberg & Johannes Bodner

  2. Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen, Rudolf-Buchheim Strasse 7, 35392, Giessen, Germany

    Emmanuel Schneck

  3. Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Florian Augustin, Dietmar Öfner & Johannes Bodner

  4. Department of Thoracic Surgery, Klinikum Bogenhausen, Englschalkinger Strasse 77, 81925, Munich, Germany

    Johannes Bodner

Authors
  1. Martin Reichert
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  2. Stefanie Kerber
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  3. Bernd Pösentrup
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  7. Dietmar Öfner
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Corresponding author

Correspondence to Martin Reichert.

Ethics declarations

The data are collected and the manuscript is written and submitted in accordance to the COPE guidelines.

The study was approved by the local ethics committee. For this type of study, formal consent is not required. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflicts of interest

There is no funding or grants received for this article. The authors declare that they have no conflicts of interest. A conflict of interest statement form according to ICMJE is subscribed by each author and submitted with the manuscript.

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Reichert, M., Kerber, S., Pösentrup, B. et al. Anatomic lung resections for benign pulmonary diseases by video-assisted thoracoscopic surgery (VATS). Langenbecks Arch Surg 401, 867–875 (2016). https://doi.org/10.1007/s00423-016-1478-0

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  • DOI: https://doi.org/10.1007/s00423-016-1478-0

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