Feasibility of video-assisted thoracoscopic surgery lobectomy in Veterans Administration patients.
BACKGROUND
Video-assisted thoracoscopic surgery (VATS) pulmonary lobectomy has been associated with decreased complication rates and length of stay compared with lobectomy by thoracotomy. No studies have addressed VATS lobectomy in Veterans Administration (VA) patients.


METHODS
A retrospective review was undertaken of 50 VATS lobectomies performed between August 2007 and June 2009 by one surgeon in a VA hospital, a university-affiliated county hospital, and a private community hospital.


RESULTS
VA patients had more medical comorbidities, poorer lung function, greater current smoker status, and fewer preoperative biopsies. Pleural adhesions or hilar lymphadenopathy were encountered more commonly in VA than nonfederal patients. Surgical times and number of procedures performed were greater in VA patients. There was no statistically significant difference in the risk of postoperative complications or chest tube duration although length of stay was longer for VA patients.


CONCLUSIONS
VATS lobectomy is feasible in a VA setting. The evidence strongly suggests that veterans can benefit from VATS lobectomy in terms of improved outcomes and diminished length of stay compared with thoracotomy.
Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA. dearmond@uthscsa.edu
Daniel T
DT
DeArmond
Jeremy D
JD
Simmons
Adam M
AM
Cline
Lee Ann
LA
Zarzabal
Scott B
SB
Johnson
Clinton E
CE
Baisden
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006764:Hospitals, Community; D006766:Hospitals, County; D016304:Hospitals, Private; D006785:Hospitals, University; D006787:Hospitals, Veterans; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013781:Texas; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health / Q000706:statistics & numerical data*