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P179 Outcomes for right versus left lung malignancies after robotic-assisted pulmonary lobectomy

A. Groshev; F. Velez-Cubian; R. Gerard; K. Toosi; C. Moodie; J. Garrett; J. Fontaine; E. Toloza
Author and Funding Information

1University of South Florida Health Morsani College of Medicine

2Surgery, University of South Florida Health Morsani College of Medicine

3Thoracic Oncology, Moffitt Cancer Center

4Surgery; Oncologic Sciences, University of South Florida Health Morsani College of Medicine, Tampa, United States


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


Chest. 2017;151(5_S):A77. doi:10.1016/j.chest.2017.04.082
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Introduction: In this study, we examined asymmetry of lung malignancies and outcomes in patients (pts) undergoing pulmonary lobectomy.

Methods: We retrospectively analyzed data for all pts undergoing robotic-assisted pulmonary lobectomy for cancer by one surgeon between Sept. 2010 and Aug. 2016. We analyzed laterality of lung resection and perioperative outcomes.

Results: A total of 374 pts (mean age, 67±1 yr; range 24-87 yr), were included, with 42.5% males vs 57.5% females. Most common histologies were adenocarcinoma (61%) and squamous cell (19%), neuroendocrine (8.5%), and adenosquamous (1%) carcinomas. Both primary lung cancers and metastases were more prevalent on the right (p=0.005), with 64.6% of primary cancers on the right vs 35.4% on the left (p=0.01) and with 72.4% of metastases on the right vs 27.6% on the left (p=0.17). Asymmetries were found in numbers of positive LN stations at levels 7, 10, 11, and 12, but only that at level 11 was significant (p=0.03). Right lobectomies had greater median estimated blood loss (EBL, 200±31 mL vs 150±19 mL; p=0.018) and median operative time (188±5 min vs 168±6 min; p=0.014). Neither overall nor urgent conversion rates to open lobectomy differed between right and left cases (overall, 6.6% vs 6.2%, p=0.88; urgent, 3.7% vs 1.5%, p=0.24), nor did intraoperative complication rates (8.2% vs 3.8%, p=0.11). Right lobectomies had longer median chest tube duration (4.0±0.4 days vs 3.0±0.5 days; p=0.03) and median hospital length of stay (LOS, 5.0±0.4 days vs 4.0±0.4 days; p=0.008). Overall postoperative complication rate was higher after right lobectomies (38.5% vs 27.7%; p=0.045). Rates of individual complications did not statistically differ between right and left in most categories, except prolonged air leak ≥7 days (22% vs 12%; p=0.007), with chyle leak (4.5% vs 0.8%; p=0.059) being not quite significant. There was no significant effect on in-hospital mortality (right, 1.6%, vs left, 0%; p=0.14) or on 1-year mortality (right, 12%, vs left, 10%; p=0.51).

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