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Original Research: Cardiothoracic Surgery |

Cross-sectional Survey on Lobectomy Approach (X-SOLA)Cross-sectional Survey on Lobectomy Approach

Christopher Cao, MBBS; David H. Tian, BMed; Kevin Wolak, BMed; Jonathan Oparka, MD; Jianxing He, MD, PhD; Joel Dunning, MD; William S. Walker, MD; Tristan D. Yan, PhD
Author and Funding Information

From the Collaborative Research (CORE) Group (Drs Cao, Oparka, Dunning, and Yan and Messrs Tian and Wolak), Sydney, NSW, Australia; Department of Cardiothoracic Surgery (Dr Cao), St. George Hospital, University of New South Wales, Sydney, NSW, Australia; Department of Cardiothoracic Surgery (Dr He), The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China; Department of Cardiothoracic Surgery (Dr Walker), Royal Infirmary of Edinburgh, Scotland; and Department of Cardiothoracic Surgery (Dr Yan), Royal Prince Alfred Hospital, The University of Sydney, Sydney, NSW, Australia.

CORRESPONDENCE TO: Jianxing He, MD, PhD, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical College, No. 151 Yanjiang Rd, Guangzhou 510120, Guangdong Province, China; e-mail: drjianxing.he@gmail.com


FOR EDITORIAL COMMENT SEE PAGE 246

FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details


Chest. 2014;146(2):292-298. doi:10.1378/chest.13-1075
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BACKGROUND:  Lobectomy for non-small cell lung cancer (NSCLC) can be performed either through open thoracotomy or video-assisted thoracoscopic surgery (VATS). To improve the understanding of current attitudes of the thoracic community toward VATS lobectomy, the Collaborative Research Group conducted the Cross-sectional Survey on Lobectomy Approach (X-SOLA) study. We surveyed a large cohort of lobectomy-performing thoracic surgeons to examine their adoption of VATS lobectomy and their opinions of this technique vs conventional open thoracotomy.

METHODS:  Participants included thoracic surgeons identified through an international index search from the Web of Science and the cardiothoracic surgery network. A confidential questionnaire was e-mailed in June 2012. Nonresponders were given two reminder e-mails at monthly intervals.

RESULTS:  The questionnaire, completed by 838 thoracic surgeons within a 3-month period, identified 416 surgeons who only performed lobectomy through open thoracotomy and 422 surgeons who performed VATS or robotic VATS. Of those who performed VATS, 95% agreed with the definition of “true” VATS lobectomy according to the Cancer and Leukemia Group B trial. Ninety-two percent of surgeons who did not perform VATS lobectomy responded that they were willing to learn this technique, but were hindered by limited resources, exposure, and mentoring. Both groups agreed there was a need for VATS lobectomy training in thoracic residency programs and in standardized workshops.

CONCLUSIONS:  X-SOLA represents the largest cross-sectional report within the thoracic community to date, demonstrating the penetration of VATS lobectomy for NSCLC internationally. From our study, we were able to identify a number of obstacles to broaden the adoption of this minimally invasive technique.

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