[Complications after pulmonary segmentectomy: Impact of the surgical approach]

Abstract

Introduction: Pulmonary segmentectomy is becoming increasingly widespread but remains technically challenging. The aim of this study was to evaluate the impact of the surgical approach applied on postoperative complications after pulmonary segmentectomy.

Methods: All patients having undergone pulmonary segmentectomy by thoracotomy, videothoracoscopy or robot-assisted surgery from 1st January 2018 to 31st December 2021 were included. The primary endpoint was the occurrence of postoperative complications. Secondary endpoints were operative time, length of hospital stay, 30-day readmission rate, 30-day and 90-day mortality.

Results: Two hundred and twenty-three patients were included, 30% (n=67) in the thoracotomy group, 9.4% (n=21) in the videothoracoscopy group and 60.5% (n=135) in the robot-assisted surgery group. There was no difference in the occurrence of postoperative complications according to type of approach (P=0.564), 26.9% of patients (n=60) had at least one postoperative complication. There was no significant difference between the groups in terms of operative time (P=0.385), length of hospital stay (P=0.107), 30 and 90-day mortality (P=0.124 and P=0.249, respectively). Mini-invasive surgery significantly reduced the 30-day readmission rate (P=0.049).

Conclusion: The surgical approach applied does not influence the postoperative complications of pulmonary segmentectomy.

Keywords: Base de données Epithor; Complications; Epithor French database; Open thoracotomy; Outcomes; RATS; Thoracotomie; VATS.