title: Is video-assisted thoracic surgery lobectomy in benign disease practical and effective?
abstract: BACKGROUND
  The aim of this study was to analyze the surgical outcomes of video-assisted thoracic surgery (VATS) lobectomy for benign pulmonary disease and to propose surgical guidelines based on the retrospective cohort study.
  
  
  METHODS
  From January 2004 to December 2009, all lobectomies performed in a university-based tertiary care hospital were analyzed. The inclusion criteria were as follows: (I) VATS lobectomy for benign disease; (II) thoracotomy conversion cases initially approached by VATS lobectomy. All malignant cases were excluded. Electronic medical records were retrospectively analyzed and patients were divided into two groups: with infection and without infection. The primary outcomes were the thoracotomy conversion rate, length of hospital stay, period of thoracic drainage and complications.
  
  
  RESULTS
  VATS was performed in 163 (42%) of 385 patients who underwent lobectomy for benign disease. There were 68 in the infection group and 95 in the group without infection. VATS lobectomy was successful in 157 (96%) patients while 6 were converted into thoracotomy. The mean operation time and blood loss were 160 minutes and 326 mL. Comparing two groups, operation time and blood loss were not statistically different (P value =0.92, 0.63). Moreover conversion rate, length of hospital stay, period of thoracic drainage and complications (P value =0.67, 0.18, 0.25, and 0.50) were not different.
  
  
  CONCLUSIONS
  VATS lobectomy for benign disease is practical and effective in selected cases regardless of the presence of infection. However, because various technical obstacles may be encountered during the procedure, therefore, careful patient selection is needed.
authors.affiliation: 1 Department of Thoracic and Cardiovascular surgery, Chungbuk National University Hospital, Cheongju, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, South Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, South Korea.
authors.forename: Dohun
authors.initials: D
authors.lastname: Kim
authors.affiliation: 1 Department of Thoracic and Cardiovascular surgery, Chungbuk National University Hospital, Cheongju, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, South Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, South Korea.
authors.forename: Hong Kwan
authors.initials: HK
authors.lastname: Kim
authors.affiliation: 1 Department of Thoracic and Cardiovascular surgery, Chungbuk National University Hospital, Cheongju, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, South Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, South Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Choi
authors.affiliation: 1 Department of Thoracic and Cardiovascular surgery, Chungbuk National University Hospital, Cheongju, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, South Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, South Korea.
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.affiliation: 1 Department of Thoracic and Cardiovascular surgery, Chungbuk National University Hospital, Cheongju, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, South Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, South Korea.
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
authors.affiliation: 1 Department of Thoracic and Cardiovascular surgery, Chungbuk National University Hospital, Cheongju, South Korea ; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, South Korea ; 3 Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, South Korea.
authors.forename: Kwhanmien
authors.initials: K
authors.lastname: Kim
keywords: Minimally invasive surgery; lobectomy (lung); lung benign or congenital lesions