Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec;33(12):3953-3962.
doi: 10.1007/s00464-019-06682-5. Epub 2019 Jan 31.

Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database

Stefano Bongiolatti  1 , Alessandro Gonfiotti  2 , Domenico Viggiano  2 , Sara Borgianni  2 , Leonardo Politi  2 , Roberto Crisci  3 , Carlo Curcio  4 , Luca Voltolini  2 ; Italian VATS Group
Collaborators, Affiliations

Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database

Stefano Bongiolatti et al. Surg Endosc. 2019 Dec.

Erratum in

Abstract

Objective: The objective of the study is to analyse the causes and impact of conversion from VATS to thoracotomy identifying any possible pre-operative risk factors and related consequences.

Methods: Data from patient who underwent VATS lobectomy (VATS-L) for NSCLC at VATS Group participating centres were retrospectively analysed and divided in two groups: patients treated with VATS-L and patients who suffered from conversion. Predictors of conversion were assessed with univariate and multivariable exact logistic regression. Complications were evaluated as dependent variables of conversion in a Cox multivariable logistic regression model.

Results: A total of 4629 patients underwent planned VATS-L for NSCLC and of these, 432 (9.3%) required conversion; the most frequent causes were bleeding (30.4%) and fibro-calcified hilar lymph nodes (23.9%). The independent risk factors at multivariable analysis model were sex male (OR 1.458, p < 0.01), age older than 70 years (OR 1.248, p = 0.036) and the clinically node-positive disease (OR 2.258, p < 0.01). The mortality rate was similar, but the percentage of patients who suffered from any complication (41.7% vs 24.4%, p < 0.01), the complication rate (65% vs 32.2%, p < 0.01), chest tube duration (p < 0.01) and the hospitalisation rate (p < 0.01) were higher for patients converted. Atrial fibrillation (OR 1.471, p = 0.019), prolonged air leak (OR 1.403, p = 0.043), blood transfusions (OR 4.820, p < 0.01), sputum retention (OR 1.80, p = 0.027) and acute kidney failure (OR 2.758, p = 0.03) were significantly associated with conversion at multivariable analysis.

Conclusions: Conversion is associated with increased surgical morbidity, blood loss and hospital stay. Sex male, old age and the clinical involvement of lymph nodes were the strongest predictors of conversion.

Keywords: Complications; Conversion; Lobectomy; Lung cancer; Video-assisted thoracic surgery.

PubMed Disclaimer

References

    1. Eur J Cardiothorac Surg. 2018 Oct 1;54(4):664-670 - PubMed
    1. Interact Cardiovasc Thorac Surg. 2011 Jun;12(6):962-4 - PubMed
    1. J Vis Surg. 2017 Nov 07;3:160 - PubMed
    1. Ann Surg. 2006 Sep;244(3):420-5 - PubMed
    1. Surgery. 2005 Sep;138(3):510-7 - PubMed

LinkOut - more resources