Portal de Periódicos da CAPES

Thoracoscopic segmentectomy versus lobectomy: A propensity score–matched analysis

2022; Elsevier BV; Volume: 9; Linguagem: Inglês

10.1016/j.xjon.2022.01.009

2666-2736

Julio Sesma, Sergio Bolufer, Antonio García-Valentín, Raúl Embún Flor, Iker Lopez, Nicolás Moreno‐Mata, Unai Jiménez, Florentino Hernándo, Antonio E. Martin-Ucar, Juana Gallar, Raúl Embún Flor, Íñigo Royo-Crespo, José Luis Recuero Díaz, Sergio Bolufer, Julio Sesma, Sergi Call, Miguel Congregado, David Gómez de Antonio, Marcelo F. Jiménez, Nicolás Moreno‐Mata, Borja Aguinagalde, Sergio Amor-Alonso, Miguel Jesús Arrarás, Ana Isabel Blanco Orozco, Marc Boada, Alberto Cabañero-Sánchez, Isabel Cal Vázquez, Ángel Cilleruelo Ramos, Silvana Crowley Carrasco, Elena Fernández-Martín, Santiago García-Barajas, María Dolores García-Jiménez, José María García-Prim, José Alberto García-Salcedo, Juan José Gelbenzu-Zazpe, Carlos Fernando Giraldo-Ospina, María Teresa Gómez-Hernández, Jorge Hernández, Jennifer D. Illana Wolf, Alberto Jáuregui Abularach, Unai Jiménez, Iker López Sanz, Néstor J. Martínez‐Hernández, Elisabeth Martínez-Téllez, Lucía Milla Collado, Roberto Mongil Poce, Javier Moradiellos, Ramón Moreno‐Balsalobre, Sergio B. Moreno Merino, Carme Obiols, Florencio Quero‐Valenzuela, María Elena Ramírez-Gil, Ricard Ramos-Izquierdo, Eduardo Rivo, Alberto Rodríguez-Fuster, Rafael Rojo-Marcos, David Sánchez-Lorente, Laura Moreno, Carlos Simón, Juan Carlos Trujillo-Reyes, Florentino Hernándo,

Congenital Diaphragmatic Hernia Studies

The aim of this study is to compare the postoperative complications, perioperative course, and survival among patients from the multicentric Spanish Video-assisted Thoracic Surgery Group database who received video-assisted thoracic surgery lobectomy or video-assisted thoracic surgery anatomic segmentectomy.From December 2016 to March 2018, a total of 2250 patients were collected from 33 centers. Overall analysis (video-assisted thoracic surgery lobectomy = 2070; video-assisted thoracic surgery anatomic segmentectomy = 180) and propensity score-matched adjusted analysis (video-assisted thoracic surgery lobectomy = 97; video-assisted thoracic surgery anatomic segmentectomy = 97) were performed to compare postoperative results. Kaplan-Meier and competing risks method were used to compare survival.In the overall analysis, video-assisted thoracic surgery anatomic segmentectomy showed a lower incidence of respiratory complications (relative risk, 0.56; confidence interval, 0.37-0.83; P = .002), lower postoperative prolonged air leak (relative risk, 0.42; 95% confidence interval, 0.23-0.78; P = .003), and shorter median postoperative stay (4.8 vs 6.2 days; P = .004) than video-assisted thoracic surgery lobectomy. After propensity score-matched analysis, prolonged air leak remained significantly lower in video-assisted thoracic surgery anatomic segmentectomy (relative risk, 0.33; 95% confidence interval, 0.12-0.89; P = .02). Kaplan-Meier and competing risk curves showed no differences during the 3-year follow-up (median follow-up in months: 24.4; interquartile range, 20.8-28.3) in terms of overall survival (hazard ratio, 0.73; 95% confidence interval, 0.45-1.7; P = .2), tumor progression-related mortality (subdistribution hazard ratio, 0.41; 95% confidence interval, 0.11-1.57; P = .2), and disease-free survival (subdistribution hazard ratio, 0.73; 95% confidence interval, 0.35-1.51; P = .4) between groups.Video-assisted thoracic surgery segmentectomy showed results similar to lobectomy in terms of postoperative outcomes and midterm survival. In addition, a lower incidence of prolonged air leak was found in patients who underwent video-assisted thoracic surgery anatomic segmentectomy.