Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database

摘要: OBJECTIVES: Video-assisted thoracoscopic anatomical resections are increasingly used in Europe to manage primary lung cancer. The purpose of this study was compare the outcome following versus open lobectomy case-matched groups patients from European Society Thoracic Surgeon (ESTS) database. METHODS: All having as procedure via thoracoscopy [video-assisted surgery (VATS)-L)] or thoracotomy (TH-L) were identified ESTS database (January 2007 December 2013). A propensity score constructed using several patients’ baseline characteristics. matching responsible for minimization selection bias. score-matched analysis performed incidence postoperative major complications (according definitions) and mortality at hospital discharge between matched groups. After exclusions, 28 771 identified: 26 050 2721 thoracoscopy. Propensity yielded two well-matched patients. Numeric variables compared by Student’s t-tests categorical McNemar’s tests. RESULTS: Compared with TH-L, VATS-L associated a lower total [n= 792 (29.1%) vs 863 (31.7%), P= 0.0357], cardiopulmonary 316 (15.9%) 435 (19.6%), 0.0094], atelectasis requiring bronchoscopy [n=65 (2.4%) 150 (5.5%), P 48 h 18 (0.7%) 38 (1.4%), 0.0075] wound infection 6 (0.2%) 17 (0.6%), 0.0218]. There no difference atrial fibrillation (P= 0.14). Postoperative stay 2 days shorter (mean: 7.8 9.8 days; 0.0003). In terms discharge, there 27 deaths group (1%) 50 TH-L (1.9%, 0.0201). CONCLUSIONS: Data confirmed that through VATS is thoracotomy.