Discharge independence with minimally invasive lobectomy.
BACKGROUND
The effects of video-assisted thoracic surgery (VATS) pulmonary lobectomy on after-hospital care are not well known.


METHODS
In a retrospective case-control study, 20 consecutive VATS cases were matched to 38 standard thoracotomies (open cases).


RESULTS
Ages were 73.8 +/- 7.8 years with no initial differences between the groups. No hospital deaths occurred. Excluding 2 VATS and 6 open outliers, VATS cases had fewer hospital days (4.6 +/- 1.9 vs. 6.4 +/- 2.2, P <0.01), chest tube days (3.0 +/- 1.1 vs. 4.2 +/- 1.7, P = 0.01), and prolonged pain complaints (28% vs. 56%, P = 0.05). Transfer to care facilities or home nursing support was needed for 63% of open patients and only 20% of VATS patients (P = 0.015). Less personal care (10% vs. 21%), wound/medical care (0% vs. 13%), occupational/physical therapy (5% vs. 13%), or other home support (5% vs. 18%) was needed for VATS patients.


CONCLUSIONS
In older populations, more independence and fewer resources after discharge favor VATS lobectomy over standard thoracotomy.
Demmy
Todd L
TL
Department of Thoracic Surgery, Roswell Park Cancer Institute, Elm and Carlton St., Buffalo, NY 14263, USA. Todd.Demmy@roswellpark.org
Plante
Andrew J
AJ
Nwogu
Chukwumere E
CE
Takita
Hiroshi
H
Anderson
Timothy M
TM
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003266:Continuity of Patient Care / Q000592:standards* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010351:Patient Discharge / Q000592:standards* / Q000639:trends; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome