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Oral Sessions: Session 20: Free Communications - Lung cancer and thoracic surgery |

122 Clinical and oncological safety of 129 pulmonary segmentectomies by VATS

B. Bédat; E. Abdelnour; T. Krueger; J. Perentes; L. Wannaz; H.-B. Ris; F. Triponez; W. Karenovics; M. Gonzalez
Author and Funding Information

1Hôpitaux Universitaires de Genève, Genève

2Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland


Copyright 2017, American College of Chest Physicians and Swiss Respiratory Society SGP. All Rights Reserved.


Chest. 2017;151(5_S):A19. doi:10.1016/j.chest.2017.04.021
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Background: Pulmonary anatomical segmentectomies are increasingly performed by video-assisted thoracoscopic surgery (VATS). The aim of this study was to review the demographics, short term oncological outcome and define predictors of complications after anatomical VATS segmentectomies.

Methods: Prospective analysis of all patients undergoing anatomical VATS segmentectomy from 1/2014 to 12/2016 at our institution.

Results: One hundred and twenty-nine patients (64 men, 65 women; median age 68 years, range 29-85 years) underwent anatomical VATS segmentectomy for primary lung tumors (n=100), metastases (n=16) and benign lesions (n=13). The segmentectomies were localized in the upper and lower lobe or two lobes in 73, 51 and 5 patients, respectively. Segmentectomies performed for primary tumors revealed adenocarcinoma, squamous cell carcinoma and neuro-endocrine tumors in 77, 15 and 8 patients, associated with pT1, pT2, pT3 and pT4 tumors in 80, 17, 1 and 2 patients, respectively. The mean tumor size was 17mm (range 6-48mm). In patients undergoing mediastinal lymph node dissection, the mean number of extracted lymph nodes was 11.8 ±7.9 and nodal upstaging was found in 8 patients (8%). The overall 30 days mortality and morbidity rates were 0.8% and 31%, respectively. The reoperation rate was 4.7% (hemothorax 2, prolonged air leak 2, segmental torsion 1, empyema 1). The median duration of drainage was 2 days (range 1-33 days) and the median length of hospitalization was 6 days (range 2-37 days). COPD, active smoking, smoking pack years (SPY) and FEV1 were significantly associated with postoperative complications; however, there was no statistical difference comparing the first 50 cases with consecutive patients. During the median follow-up of 10 months, no oncological patient presented a local recurrence in the operated lobe.

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