Video-assisted minithoracotomy versus muscle-sparing thoracotomy for performing lobectomy.
We prospectively analyzed the outcome of lobectomy in a cohort of 67 patients. Operative time, postoperative pain, pulmonary function, and early outcome were compared between the patients undergoing video-assisted techniques (n = 44) and those undergoing standard muscle-sparing procedures (n = 23). Pain was quantified daily throughout the first week using the visual analog scale. The forced expiratory volume in 1 second and the forced vital capacity were measured at days 2, 4, and 8 postoperatively. The operative time was significantly longer (p < 0.02) and the postoperative pain was significantly less (p < 0.006) in the group undergoing video-assisted procedures. Pain-related morbidity, the mean duration of air leaks, the duration of chest tube placement, and the hospital stay were all less in the video-assisted group, but the differences did not reach statistical significance. However, the impairment in pulmonary function and the overall morbidity were identical for the two groups. Based on our findings, we conclude that video-assisted minithoracotomy is a safe and reliable approach for performing lobectomies, and that the decreased postoperative pain associated with this minimally invasive approach does not result in preserved pulmonary function and significantly reduced morbidity when compared with a muscle-sparing thoracotomy.
Giudicelli
R
R
Department of Thoracic Surgery and Lung Transplantation, Sainte-Marguerite University Hospital, Marseilles, France.
Thomas
P
P
Lonjon
T
T
Ragni
J
J
Morati
N
N
Ottomani
R
R
Fuentes
P A
PA
Shennib
H
H
Noirclerc
M
M
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording