title: Is it safe to perform completion lobectomy after diagnostic wedge resection using video-assisted thoracoscopic surgery?
abstract: OBJECTIVE
  The objective of this study was to assess the safety of video-assisted thoracoscopic surgery (VATS) completion lobectomy (CL) for non-small cell lung cancer (NSCLC) after diagnostic wedge resection by comparing with standard VATS lobectomy (SL).
  
  
  METHODS
  Data were retrieved from an institutional database of consecutive VATS lobectomies between January 1st 2007 and December 31st 2013. Patients were grouped into CL or SL. Patient characteristics, operative data, converted procedures, complications, and mortality was compared using Pearson Chi square, Fisher's exact test, or Mann-Whitney U test.
  
  
  RESULTS
  In total 80 CL and 958 SLs were performed. There were no significant differences in median operating time, median chest drain duration or median length of stay. Median operative bleeding was 100 mL (IQR 50-238) in the CL group compared to 75 mL (IQR 25-200) in the SL group (p = 0.01). There were no differences between groups in major or minor complications. Median time from VATS wedge resection to CL was 33 days (IQR 27-41). Conversion rate was 1.3% in the CL group and 2.6% in the SL group (p = 0.72). 30-day mortality was 0 vs. 1.1 % for the CL group and the SL group accordingly (p > 0.99).
  
  
  CONCLUSIONS
  This study comparing short-term surgical outcome and complications after surgical treatment of NSCLC indicates that VATS completion lobectomy after diagnostic wedge resection seems safe when looking at a relatively short time interval between the two procedures.
authors.affiliation: Department of Cardiothoracic Surgery, RT-2152, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. bo.laksafoss.holbek@regionh.dk.|Section for Surgical Pathophysiology, JMC-7621, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. bo.laksafoss.holbek@regionh.dk.
authors.forename: Bo Laksáfoss
authors.initials: BL
authors.lastname: Holbek
authors.affiliation: Department of Cardiothoracic Surgery, RT-2152, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: René Horsleben
authors.initials: RH
authors.lastname: Petersen
authors.affiliation: Department of Cardiothoracic Surgery, RT-2152, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: Henrik Jessen
authors.initials: HJ
authors.lastname: Hansen
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011612:Psychosurgery / Q000379:methods; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*
keywords: Complications; Length of stay; Neoplasms; Reoperation; Video-assisted thoracoscopic surgery