What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry

the Italian VATS group members, Maurizio V. Infante, Cristiano Benato, Ronaldo Silva, Gaetano Rocco, Alessandro Bertani, Luca Bertolaccini, Alessandro Gonfiotti, Riccardo Giovannetti, Cinzia Bonadiman, Alessandro Lonardoni, Barbara Canneto, Giovanni Falezza, Paola Gandini, Carlo Curcio, Roberto Crisci, Francesco Zaraca, Marco Alloisio, Dario Amore, Luca AmpolliniClaudio Andreetti, Desideria Argnani, Guido Baietto, Alessandro Bandiera, Mauro Roberto Benvenuti, Luigi Bortolotti, Edoardo Bottoni, Cristiano Breda, Pierpaolo Camplese, Paolo Carbognani, Giuseppe Cardillo, Caterina Casadio, Giorgio Cavallesco, Roberto Cherchi, Andrea Dell'Amore, Vittorio Della Beffa, Giampiero Dolci, Andrea Droghetti, Paolo A. Ferrari, Diego Fontana, Gaetano Gargiulo, Roberto Gasparri, Stefano Margaritora, Elisa Meacci, Giampiero Negri, Mario Nosotti, Lorenzo Rosso, Emanuele Russo, Lorenzo Spaggiari, Alessandro Stefani, Piergiorgio Solli

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Inherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons' ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry. METHODS: The registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications. RESULTS: Four thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3-6). Grade 1 and 2 and Grade 3-5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (
Original languageEnglish
Pages (from-to)1097-1103
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume56
Issue number6
DOIs
Publication statusPublished - Dec 1 2019

Keywords

  • Conversion
  • Morbidity
  • Postoperative complications
  • Video-assisted thoracoscopic surgery lobectomy

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