title: Consistently lower narcotics consumption after video-assisted thoracoscopic surgery for early stage non-small cell lung cancer when compared to open surgery: a one-year follow-up study.
abstract: OBJECTIVE
  Video-assisted thoracoscopic surgery (VATS) is possibly associated with reduced acute pain and narcotics consumption when compared to open surgery, but little is known about the long-term effect. The goal of our study was to evaluate whether narcotics consumption is consistently lower after VATS for early stage non-small cell lung cancer (NSCLC), as compared to open surgery, during one-year follow-up.
  
  
  METHODS
  This nationwide retrospective cohort study was conducted using data relating to cancer registry and national compulsory comprehensive claims in Taiwan. Our study cases were those newly diagnosed with clinical Stage I NSCLC, who underwent primary lung resection in the year 2007. The date of the admission during which index surgery was performed was used as the index date. We compared the use of narcotics, between the VATS and open surgery groups, over a period of one year following the index date. We defined narcotics as either Level 1 or 2 drugs as regulated in Taiwan. We also used an equiananalgesic dose chart to convert drug consumption into a uniform narcotics equivalent dose. Chi-square and t-tests were used for statistical analysis.
  
  
  RESULTS
  We identified 329 cases (114 for VATS and 215 for open surgery). These two groups were balanced for most clinical variables. VATS was associated with lower narcotics consumption during the index admission (mean equivalent dose of intravenous morphine: 54.6 vs 71.4 mg) and this trend extended to the period covering the 2nd to 12th month after index date (73.8 vs 149.5mg).
  
  
  CONCLUSIONS
  Narcotics consumption is consistently lower after VATS for early stage NSCLC, as compared to open surgery. Further prospective studies would be of great value in validating this finding.
authors.affiliation: Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hsin-Yuan
authors.initials: HY
authors.lastname: Fang
authors.forename: Chih-Yi
authors.initials: CY
authors.lastname: Chen
authors.forename: Yao-Ching
authors.initials: YC
authors.lastname: Wang
authors.forename: Pin-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Shwn-Huey
authors.initials: SH
authors.lastname: Shieh
authors.forename: Chun-Ru
authors.initials: CR
authors.lastname: Chien
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D009294:Narcotics