title: Anatomic pulmonary resection by video-assisted thoracoscopy: the Brazilian experience (VATS Brazil study).
abstract: OBJECTIVE
  The objective of this study was to describe the results of anatomic pulmonary resections performed by video-assisted thoracoscopy in Brazil.
  
  
  METHODS
  Thoracic surgeons (members of the Brazilian Society of Thoracic Surgery) were invited, via e-mail, to participate in the study. Eighteen surgeons participated in the project by providing us with retrospective databases containing information related to anatomic pulmonary resections performed by video-assisted thoracoscopy. Demographic, surgical, and postoperative data were collected with a standardized instrument, after which they were compiled and analyzed.
  
  
  RESULTS
  The surgeons provided data related to a collective total of 786 patients (mean number of resections per surgeon, 43.6). However, 137 patients were excluded because some data were missing. Therefore, the study sample comprised 649 patients. The mean age of the patients was 61.7 years. Of the 649 patients, 295 (45.5%) were male. The majority-521 (89.8%)-had undergone surgery for neoplasia, which was most often classified as stage IA. The median duration of pleural drainage was 3 days, and the median hospital stay was 4 days. Of the 649 procedures evaluated, 598 (91.2%) were lobectomies. Conversion to thoracotomy was necessary in 30 cases (4.6%). Postoperative complications occurred in 124 patients (19.1%), the most common complications being pneumonia, prolonged air leaks, and atelectasis. The 30-day mortality rate was 2.0%, advanced age and diabetes being found to be predictors of mortality.
  
  
  CONCLUSIONS
  Our analysis of this representative sample of patients undergoing pulmonary resection by video-assisted thoracoscopy in Brazil showed that the procedure is practicable and safe, as well as being comparable to those performed in other countries.
  
  
  OBJECTIVE
  O objetivo deste estudo foi descrever os resultados de ressecções pulmonares anatômicas por videotoracoscopia no Brasil.
  Cirurgiões torácicos (membros da Sociedade Brasileira de Cirurgia Torácica) foram convidados, por correio eletrônico, a participar do estudo. Dezoito cirurgiões participaram do projeto enviando seus bancos de dados retrospectivos referentes a ressecções anatômicas de pulmão por videotoracoscopia. Dados demográficos, cirúrgicos e pós-operatórios foram coletados em um instrumento padronizado e posteriormente compilados e analisados.
  
  
  RESULTS
  Dados referentes a 786 pacientes foram encaminhados (média de 43,6 ressecções por cirurgião), sendo 137 excluídos por informações incompletas. Logo, 649 pacientes constituíram nossa população estudada. A média de idade dos pacientes foi de 61,7 anos, 295 eram homens (45,5%), e a maioria - 521 (89,8%) - foi submetida à cirurgia por neoplasia, mais frequentemente classificada como estádio IA. A mediana do tempo de drenagem pleural foi de 3 dias, e a do tempo de internação, 4 dias. Dos 649 procedimentos realizados, 598 (91,2%) foram lobectomias. A taxa de conversão para toracotomia foi de 4,6% (30 casos). Complicações pós-operatórias ocorreram em 124 pacientes (19,1%), sendo pneumonia, escape aéreo prolongado e atelectasia as mais frequentes. A mortalidade em 30 dias foi de 2,0%, tendo como preditores idade avançada e diabetes.
  A casuística brasileira mostra que as ressecções pulmonares por cirurgia torácica videoassistida são factíveis e seguras, além de comparáveis àquelas de registros internacionais.
authors.affiliation: Departamento de Cardiopneumologia, Disciplina de Cirurgia Torácica, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.
authors.forename: Ricardo Mingarini
authors.initials: RM
authors.lastname: Terra
authors.affiliation: Departamento de Cardiopneumologia, Disciplina de Cirurgia Torácica, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.
authors.forename: Thamara
authors.initials: T
authors.lastname: Kazantzis
authors.affiliation: Serviço de Cirurgia Torácica, Hospital Geral de Caxias do Sul, Fundação Universidade de Caxias do Sul (RS) Brasil.
authors.forename: Darcy Ribeiro
authors.initials: DR
authors.lastname: Pinto-Filho
authors.affiliation: Serviço de Cirurgia Torácica, Pavilhão Pereira Filho, Complexo Hospitalar da Santa Casa de Porto Alegre, Porto Alegre (RS) Brasil.
authors.forename: Spencer Marcantonio
authors.initials: SM
authors.lastname: Camargo
authors.affiliation: Hospital Monte Klinikum, Fortaleza (CE) Brasil.|Hospital de Messejana Doutor Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martins-Neto
authors.affiliation: Casa de Saúde São José, Rio de Janeiro (RJ) Brasil.
authors.forename: Anderson Nassar
authors.initials: AN
authors.lastname: Guimarães
authors.affiliation: Universidade Federal do Rio Grande do Norte, Natal (RN) Brasil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Araújo
authors.affiliation: Hospital Professor Edmundo Vasconcelos, São Paulo (SP) Brasil.
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Losso
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo (SP) Brasil.
authors.forename: Mario Claudio
authors.initials: MC
authors.lastname: Ghefter
authors.affiliation: Hospital de Base do Distrito Federal, Brasília (DF) Brasil.
authors.forename: Nuno Ferreira de
authors.initials: NF
authors.lastname: Lima
authors.affiliation: Hospital de Messejana Doutor Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil.
authors.forename: Antero
authors.initials: A
authors.lastname: Gomes-Neto
authors.affiliation: Hospital de Base do Distrito Federal, Brasília (DF) Brasil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Brito-Filho
authors.affiliation: Hospital Samaritano, Rio de Janeiro (RJ) Brasil.
authors.forename: Rui
authors.initials: R
authors.lastname: Haddad
authors.affiliation: Serviço de Cirurgia Torácica, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS) Brasil.
authors.forename: Maurício Guidi
authors.initials: MG
authors.lastname: Saueressig
authors.affiliation: Hospital Geral César Cals, Fortaleza (CE) Brasil.
authors.forename: Alexandre Marcelo Rodrigues
authors.initials: AM
authors.lastname: Lima
authors.affiliation: Hospital de Messejana Doutor Carlos Alberto Studart Gomes, Fortaleza (CE) Brasil.
authors.forename: Rafael Pontes de
authors.initials: RP
authors.lastname: Siqueira
authors.affiliation: Instituto Mário Penna, Hospital Luxemburgo, Belo Horizonte (MG) Brasil.
authors.forename: Astunaldo Júnior de Macedo E
authors.initials: AJ
authors.lastname: Pinho
authors.affiliation: Hospital Naval Marcílio Dias, Rio de Janeiro (RJ) Brasil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Vannucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007902:Length of Stay; D008168:Lung / Q000601:surgery*; D008171:Lung Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult