scholarly journals Computed tomography-guided dye localization prior to uniportal thoracoscopic surgery for lung nodules: A propensity score matching analysis

2019 ◽  
Vol 118 (4) ◽  
pp. 783-789 ◽  
Author(s):  
Tung-Ming Tsai ◽  
Wan-Ting Hung ◽  
Mong-Wei Lin ◽  
Hsao-Hsun Hsu ◽  
Jin-Shing Chen
Keyword(s):  
Computed Tomography ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Thoracoscopic Surgery ◽  
Lung Nodules ◽  
Propensity Score Matching Analysis

scholarly journals Electromagnetic navigation-guided versus computed tomography-guided percutaneous localization of small lung nodules before uniportal video-assisted thoracoscopic surgery: a propensity score-matched analysis

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i85-i91 ◽  
Author(s):  
Chia-Tsung Hung ◽  
Chun-Ku Chen ◽  
Ying-Yueh Chang ◽  
Po-Kuei Hsu ◽  
Jung-Jyh Hung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Propensity Score ◽  
Thoracoscopic Surgery ◽  
Preoperative Localization ◽  
Lung Nodules ◽  
Complication Rates ◽  
Surgical Results ◽  
Ct Guided ◽  
Electromagnetic Navigation ◽  
Video Assisted

Abstract OBJECTIVES An optimal method for preoperative localization of small lung nodules is yet to be established, and there are few comparative studies in the literature. In the present study, we aimed to compare electromagnetic navigation-guided and computed tomography (CT)-guided methods of percutaneous transthoracic localization. METHODS The clinical, radiographic, surgical and pathological data of patients who underwent electromagnetic navigation-guided localization (EMNGL) and CT-guided localization (CTGL) before uniportal video-assisted thoracic surgery (VATS) were reviewed. Propensity score matching analysis was performed to compare the localization and surgical results. RESULTS After matching, 25 EMNGL and 50 CTGL patients were included in the analysis. In the CTGL group, pulmonary haemorrhage and pneumothorax were noted in 56% and 34% of patients, respectively, on postprocedural CT scans. Successful localization was achieved in 96% and 100% of patients in the EMNGL and CTGL groups, respectively (P = 0.333). The median time in the operation room was significantly shorter in the CTGL group {142.5 [interquartile range (IQR) 123.8–175.0] vs 205.0 [IQR 177.5–290.0] min, P < 0.001}. In contrast, EMNGL significantly decreased the total time [205.0 (IQR 177.5–290.0) vs 324.0 (IQR 228.3–374.0) min, P = 0.002]. The median duration of chest drainage was 1 day shorter in the EMNGL group [2.0 (IQR 1.5–2.5) vs 3.0 (IQR 2.0–3.0), P = 0.002]; the surgical complication rates were comparable between the 2 groups. CONCLUSIONS The localization and surgical results were similar between the EMNGL and CTGL groups. EMNGL is comparable to conventional CTGL with respect to preoperative localization of small lung nodules before uniportal VATS.

scholarly journals Surgery performed at night by continuously working surgeons contributes to a higher incidence of intraoperative complications in video-assisted thoracoscopic pulmonary resection: a large monocentric retrospective study

2019 ◽  
Author(s):  
Chunji Chen ◽  
Xiaofeng Zhang ◽  
Chang Gu ◽  
Yiyang Wang ◽  
Kun Liu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Pulmonary Resection ◽  
Thoracoscopic Surgery ◽  
Intraoperative Complications ◽  
Working Hours ◽  
Night Time ◽  
Propensity Score Matching Analysis ◽  
Video Assisted ◽  
Independent Risk Factors

Abstract OBJECTIVES Our goal was to assess the influence of working hours and working at night on intraoperative complications on surgeons conducting video-assisted pulmonary resections. METHODS We identified all patients who underwent video-assisted thoracoscopic surgery (VATS) in Shanghai Chest Hospital from January 2015 to April 2017. Univariable and multivariable logistic analyses were used to analyse independent risk factors for intraoperative complications. A 1:4 propensity score matching analysis was conducted to verify those results. RESULTS A total of 15 767 patients who underwent VATS pulmonary resection were included in this study. Among them, 15 280 patients (96.1%) were operated on during daytime working hours and 487 (3.1%) at night. A total of 203 (1.3%) intraoperative complications occurred. Vascular injury was the main cause of intraoperative complications, accounting for 92.1% (187/203). Multivariable logistic regression indicated that age [odds ratio (OR) = 1.68, 95% confidence interval (CI) 1.43–1.98; P < 0.001], gender (OR = 1.71, 95% CI 1.26–2.32; P = 0.001), surgical experience (OR = 2.07, 95% CI 1.56–2.75; P < 0.001), type of surgery (OR = 0.31, 95% CI 0.20–0.49; P < 0.001) and operative periods (OR = 2.69, 95% CI 1.61–4.86; P < 0.001) were independent predictors for intraoperative complications. The incidence of intraoperative complications during night-time surgery was significantly higher than that during daytime working hours. A 1:4 propensity score matching-based results verification showed that night-time surgery was still an independent risk factor after propensity score matching (OR = 2.76, 95% CI 1.47–5.15; P = 0.002). CONCLUSIONS The incidence of intraoperative complications from VATS pulmonary resection performed during night hours was significantly higher than that performed during working hours. In the present labour environment, thoracic surgeons should avoid night-time surgery whenever possible.

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