Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy

Mahmoud Ismail, Dania Nachira, Marc Swierzy, Gian Maria Ferretti, Julianna Paulina Englisch, Ramin Raul Ossami Saidy, Feng Li, Harun Badakhshi, Jens C. Rueckert

Research output: Contribution to journalArticle

Abstract

Background: The combination of neoadjuvant chemotherapy and surgery in lung cancer therapy is well established. The role of uniportal video assisted thoracoscopy (VATS) is still not described in literature. This study presents the preliminary short-term results of uniportal VATS after neoadjuvant therapy in our series. Methods: The prospectively collected data of 154 patients after uniportal VATS anatomical lung resection (18 patients after neoadjuvant chemotherapy and 136 surgeries alone) were retrospectively reviewed. The perioperative results and follow-up of patients after neoadjuvant therapy were analyzed and compared to those after surgery alone. Results: The mean age of population was 67.51±10.63 years. The mean operative time was overlapping in both groups: 248.97±118.17 min in surgery group and 287.17±94.13 min in chemotherapy + surgery group (P=0.190), with no difference in terms of types of anatomical lung resections performed and number of lymph nodes retrieved. The intraoperative mortality was null in both groups. The incidence of all complications was the same in both groups and no correlations was found with any possible risk factor evaluated (age, gender, comorbidities, type of resection, histology, etc.). Among minor complications, the incidence of parenchymal fistula was significantly higher in the 18 patients underwent chemotherapy (22.2% vs. 5.1% respectively, P=0.013). The overall survival of the series was 93% at 1 year follow-up and 88% at 5-year. The 1- and 2-year survival in only surgery group was 94% and 89% respectively vs. 85% and 85% in Chemotherapy + surgery, without any significant difference (P=0.324). Conclusions: According to our experience, uniportal VATS after neoadjuvant therapy is feasible and quite safe. The oncological results and postoperative complications are comparable to those of other techniques. Uniportal VATS can be performed even for complicated cases in experienced centers.

Original languageEnglish
Pages (from-to)S3655-S3661
JournalJournal of Thoracic Disease
Volume10
DOIs
Publication statusPublished - Nov 1 2018

Fingerprint

Thoracoscopy
Drug Therapy
Lung
Neoadjuvant Therapy
Survival
Incidence
Operative Time
Combination Drug Therapy
Fistula
Comorbidity
Lung Neoplasms
Histology
Lymph Nodes
Mortality
Population

Keywords

  • Induction therapy
  • Lung cancer
  • Lung major resections
  • Uniportal video assisted thoracoscopy (uniportal VATS)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Ismail, M., Nachira, D., Swierzy, M., Ferretti, G. M., Englisch, J. P., Saidy, R. R. O., ... Rueckert, J. C. (2018). Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy. Journal of Thoracic Disease, 10, S3655-S3661. https://doi.org/10.21037/jtd.2018.06.32

Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy. / Ismail, Mahmoud; Nachira, Dania; Swierzy, Marc; Ferretti, Gian Maria; Englisch, Julianna Paulina; Saidy, Ramin Raul Ossami; Li, Feng; Badakhshi, Harun; Rueckert, Jens C.

In: Journal of Thoracic Disease, Vol. 10, 01.11.2018, p. S3655-S3661.

Research output: Contribution to journalArticle

Ismail, M, Nachira, D, Swierzy, M, Ferretti, GM, Englisch, JP, Saidy, RRO, Li, F, Badakhshi, H & Rueckert, JC 2018, 'Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy', Journal of Thoracic Disease, vol. 10, pp. S3655-S3661. https://doi.org/10.21037/jtd.2018.06.32
Ismail, Mahmoud ; Nachira, Dania ; Swierzy, Marc ; Ferretti, Gian Maria ; Englisch, Julianna Paulina ; Saidy, Ramin Raul Ossami ; Li, Feng ; Badakhshi, Harun ; Rueckert, Jens C. / Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy. In: Journal of Thoracic Disease. 2018 ; Vol. 10. pp. S3655-S3661.
@article{67d54d34fc084f7390c47aad8a538e6c,
title = "Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy",
abstract = "Background: The combination of neoadjuvant chemotherapy and surgery in lung cancer therapy is well established. The role of uniportal video assisted thoracoscopy (VATS) is still not described in literature. This study presents the preliminary short-term results of uniportal VATS after neoadjuvant therapy in our series. Methods: The prospectively collected data of 154 patients after uniportal VATS anatomical lung resection (18 patients after neoadjuvant chemotherapy and 136 surgeries alone) were retrospectively reviewed. The perioperative results and follow-up of patients after neoadjuvant therapy were analyzed and compared to those after surgery alone. Results: The mean age of population was 67.51±10.63 years. The mean operative time was overlapping in both groups: 248.97±118.17 min in surgery group and 287.17±94.13 min in chemotherapy + surgery group (P=0.190), with no difference in terms of types of anatomical lung resections performed and number of lymph nodes retrieved. The intraoperative mortality was null in both groups. The incidence of all complications was the same in both groups and no correlations was found with any possible risk factor evaluated (age, gender, comorbidities, type of resection, histology, etc.). Among minor complications, the incidence of parenchymal fistula was significantly higher in the 18 patients underwent chemotherapy (22.2{\%} vs. 5.1{\%} respectively, P=0.013). The overall survival of the series was 93{\%} at 1 year follow-up and 88{\%} at 5-year. The 1- and 2-year survival in only surgery group was 94{\%} and 89{\%} respectively vs. 85{\%} and 85{\%} in Chemotherapy + surgery, without any significant difference (P=0.324). Conclusions: According to our experience, uniportal VATS after neoadjuvant therapy is feasible and quite safe. The oncological results and postoperative complications are comparable to those of other techniques. Uniportal VATS can be performed even for complicated cases in experienced centers.",
keywords = "Induction therapy, Lung cancer, Lung major resections, Uniportal video assisted thoracoscopy (uniportal VATS)",
author = "Mahmoud Ismail and Dania Nachira and Marc Swierzy and Ferretti, {Gian Maria} and Englisch, {Julianna Paulina} and Saidy, {Ramin Raul Ossami} and Feng Li and Harun Badakhshi and Rueckert, {Jens C.}",
year = "2018",
month = "11",
day = "1",
doi = "10.21037/jtd.2018.06.32",
language = "English",
volume = "10",
pages = "S3655--S3661",
journal = "Journal of Thoracic Disease",
issn = "2072-1439",
publisher = "AME Publishing Company",

}

TY - JOUR

T1 - Uniportal video-assisted thoracoscopy major lung resections after neoadjuvant chemotherapy

AU - Ismail, Mahmoud

AU - Nachira, Dania

AU - Swierzy, Marc

AU - Ferretti, Gian Maria

AU - Englisch, Julianna Paulina

AU - Saidy, Ramin Raul Ossami

AU - Li, Feng

AU - Badakhshi, Harun

AU - Rueckert, Jens C.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: The combination of neoadjuvant chemotherapy and surgery in lung cancer therapy is well established. The role of uniportal video assisted thoracoscopy (VATS) is still not described in literature. This study presents the preliminary short-term results of uniportal VATS after neoadjuvant therapy in our series. Methods: The prospectively collected data of 154 patients after uniportal VATS anatomical lung resection (18 patients after neoadjuvant chemotherapy and 136 surgeries alone) were retrospectively reviewed. The perioperative results and follow-up of patients after neoadjuvant therapy were analyzed and compared to those after surgery alone. Results: The mean age of population was 67.51±10.63 years. The mean operative time was overlapping in both groups: 248.97±118.17 min in surgery group and 287.17±94.13 min in chemotherapy + surgery group (P=0.190), with no difference in terms of types of anatomical lung resections performed and number of lymph nodes retrieved. The intraoperative mortality was null in both groups. The incidence of all complications was the same in both groups and no correlations was found with any possible risk factor evaluated (age, gender, comorbidities, type of resection, histology, etc.). Among minor complications, the incidence of parenchymal fistula was significantly higher in the 18 patients underwent chemotherapy (22.2% vs. 5.1% respectively, P=0.013). The overall survival of the series was 93% at 1 year follow-up and 88% at 5-year. The 1- and 2-year survival in only surgery group was 94% and 89% respectively vs. 85% and 85% in Chemotherapy + surgery, without any significant difference (P=0.324). Conclusions: According to our experience, uniportal VATS after neoadjuvant therapy is feasible and quite safe. The oncological results and postoperative complications are comparable to those of other techniques. Uniportal VATS can be performed even for complicated cases in experienced centers.

AB - Background: The combination of neoadjuvant chemotherapy and surgery in lung cancer therapy is well established. The role of uniportal video assisted thoracoscopy (VATS) is still not described in literature. This study presents the preliminary short-term results of uniportal VATS after neoadjuvant therapy in our series. Methods: The prospectively collected data of 154 patients after uniportal VATS anatomical lung resection (18 patients after neoadjuvant chemotherapy and 136 surgeries alone) were retrospectively reviewed. The perioperative results and follow-up of patients after neoadjuvant therapy were analyzed and compared to those after surgery alone. Results: The mean age of population was 67.51±10.63 years. The mean operative time was overlapping in both groups: 248.97±118.17 min in surgery group and 287.17±94.13 min in chemotherapy + surgery group (P=0.190), with no difference in terms of types of anatomical lung resections performed and number of lymph nodes retrieved. The intraoperative mortality was null in both groups. The incidence of all complications was the same in both groups and no correlations was found with any possible risk factor evaluated (age, gender, comorbidities, type of resection, histology, etc.). Among minor complications, the incidence of parenchymal fistula was significantly higher in the 18 patients underwent chemotherapy (22.2% vs. 5.1% respectively, P=0.013). The overall survival of the series was 93% at 1 year follow-up and 88% at 5-year. The 1- and 2-year survival in only surgery group was 94% and 89% respectively vs. 85% and 85% in Chemotherapy + surgery, without any significant difference (P=0.324). Conclusions: According to our experience, uniportal VATS after neoadjuvant therapy is feasible and quite safe. The oncological results and postoperative complications are comparable to those of other techniques. Uniportal VATS can be performed even for complicated cases in experienced centers.

KW - Induction therapy

KW - Lung cancer

KW - Lung major resections

KW - Uniportal video assisted thoracoscopy (uniportal VATS)

UR - http://www.scopus.com/inward/record.url?scp=85057384485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057384485&partnerID=8YFLogxK

U2 - 10.21037/jtd.2018.06.32

DO - 10.21037/jtd.2018.06.32

M3 - Article

VL - 10

SP - S3655-S3661

JO - Journal of Thoracic Disease

JF - Journal of Thoracic Disease

SN - 2072-1439

ER -