Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Factors affecting selection of operative approach and subsequent short-term outcomes after anatomic resection for lung cancer.

Phillips JD, Merkow RP, Sherman KL, DeCamp MM, Bentrem DJ, Bilimoria KY. Factors affecting selection of operative approach and subsequent short-term outcomes after anatomic resection for lung cancer. Journal of the American College of Surgeons. 2012 Aug 1; 215(2):206-15.

Related HSR&D Project(s)

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

BACKGROUND: Previous studies evaluating video-assisted thoracoscopic surgery (VATS) for lung cancer are single-institution series, suffer from small sample size, or use administrative or self-reported databases. Using a multi-institutional, standardized, and audited surgical outcomes database, our objectives were to examine preoperative factors associated with undergoing VATS vs open resection and assess subsequent perioperative outcomes. STUDY DESIGN: The American College of Surgeons National Surgical Quality Improvement Program Participant Use File was used to identify patients who underwent anatomic resection (eg, segmentectomy, lobectomy, and bi-lobectomy) for primary lung cancer (2005 to 2010). Multiple logistic regression models, including propensity scores, were developed to assess preoperative factors associated with undergoing VATS and the risk-adjusted association between operative approach and 30-day outcomes. RESULTS: Of 2,353 patients undergoing resection, 74% underwent open thoracotomy (OT) and 26% underwent VATS. After regression for confounders, factors associated with undergoing a VATS were patient age older than 75 years (odds ratio [OR] = 1.41; 95% CI, 1.05-1.90), Hispanic ethnicity (OR = 2.52; 95% CI, 1.69-3.77), and cardiothoracic surgery training (OR = 1.68; 95% CI, 1.37-2.07). Patients undergoing OT had a higher likelihood of any adverse event developing (24% vs 14%; OR = 1.76; 95% CI, 1.35-2.29), specifically pneumonia and sepsis/septic shock. Median length of stay was significantly longer in the OT group (7 vs 4 days; p < 0.001). Mortality was not significantly different for VATS vs OT after regression for confounders. CONCLUSIONS: In addition to patient factors, surgeon training can play a role in determining the operative approach offered to patients. Patients selected for VATS had a lower 30-day morbidity and shorter length of stay compared with OT anatomic resection for primary lung cancer.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.