Dataset Information

Image-guided video-assisted thoracoscopic resection (iVATS): Translation to clinical practice-real-world experience.

ABSTRACT: OBJECTIVE:We developed a novel approach for localization and resection of lung nodules, using image-guided video-assisted thoracoscopic surgery (iVATS). We report our experience of translating iVATS into clinical care. METHODS:Methodology and workflow for iVATS developed as part of the Phase I/II trial were used to train surgeons, radiologists, anesthesiologists, and radiology technologists. Radiation dose, time from induction to incision, placement of T-bar to incision and incision to closure, hospital stay, and complication rates were recorded. RESULTS:Fifty patients underwent iVATS for resection of 54 nodules in a clinical hybrid operating room (OR) by six surgeons. Fifty-two (97%) nodules were successfully resected. Forty-two (84%) patients underwent wedge resection, four (7%) lobectomies, and two (4%) segmentectomy all with lymph node dissection. Median time from induction to incision was 89?minutes (range: 13-256?minutes); T-bar placement was 14?minutes (10-29?minutes); and incision to closure, 107?minutes (41-302?minutes). Average and total procedure radiation dose were: median?=?6?mSieverts (range: 2.9-35?mSieverts). No deaths were reported and median length of stay was 3 days (range: 1-12 days). CONCLUSIONS:Translation of iVATS into clinical practice has been initiated using a safe step-wise process, combining intraoperative C-arm computed tomography scanning and thoracoscopic surgery in a hybrid OR.

SUBMITTER: Gill RR

PROVIDER: S-EPMC7383497 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Image-guided video-assisted thoracoscopic resection (iVATS): Translation to clinical practice-real-world experience.

Gill Ritu R RR Barlow Julianne J Jaklitsch Michael T MT Schmidlin Eric J EJ Hartigan Phillip M PM Bueno Raphael R

Journal of surgical oncology 20200312 8

<h4>Objective</h4>We developed a novel approach for localization and resection of lung nodules, using image-guided video-assisted thoracoscopic surgery (iVATS). We report our experience of translating iVATS into clinical care.<h4>Methods</h4>Methodology and workflow for iVATS developed as part of the Phase I/II trial were used to train surgeons, radiologists, anesthesiologists, and radiology technologists. Radiation dose, time from induction to incision, placement of T-bar to incision and incisi ...[more]

PMID: 32166751

Similar Datasets

Project description:Background:Cough is one of the shared complications after lung surgery. In this study, a prospective analysis was conducted for exploring the risk factors of persistent cough after uniportal video-assisted thoracoscopic pulmonary resection. Methods:One hundred thirty-five patients with pulmonary nodules who underwent surgical treatment in the same surgical group from November 2019 to January 2020 were enrolled in this prospective study. The severity of cough and its impact on patients' quality of life before and after surgery were assessed by the Mandarin Chinese version of the Leicester cough questionnaire (LCQ-MC), and postoperative cough was tested by the cough visual analog scale (VAS) and cough symptom score (CSS). Risk factors of cough after pulmonary resection (CAP) were determined by univariate and multivariate logistic regression analysis. Results:The incidence of postoperative cough was 24.4% (33 of 135 patients). Univariate analysis showed that gender (female), the surgical site (upper right), the resection (lobectomy), subcarinal lymph node dissection, postoperative acid reflux, length of hospitalization contributed to the development of CAP resection. Multivariate logistic regression analysis showed that the resection (lobectomy) (OR 3.590, 95% CI: 0.637-20.300, P=0.017), subcarinal lymph node dissection (OR 4.420, 95% CI: 1.342-14.554, P=0.001), postoperative acid reflux (OR 13.55, 95% CI: 3.186-57.633, P<0.001) and duration of anesthesia (over 153 minutes, OR 0.987, 95% CI: 0.978-0.997, P=0.011) were independent risk factors for postoperative cough. Conclusions:The application of uniportal video-assisted thoracoscopic techniques to several types of lung surgery are conducive to enhanced recovery after surgery (ERAS). Postoperative cough is related to an ocean of factors, the resection (lobectomy), subcarinal lymph node dissection, postoperative acid reflux, and duration of anesthesia (over 153 minutes) are independent high-risk factors for CAP resection. Trial registration:This study was registered on ClinicalTrials.gov (NCT04204148).

Project description:BACKGROUND:Uniportal video-assisted thoracoscopic surgery (U-VATS) has recently emerged as an alternative procedure for non-small cell lung cancer (NSCLC); however, whether U-VATS has advantages over multiportal VATS (M-VATS) remains unknown. METHODS:We performed a systematic review of two databases (Pubmed and Web of Science) to search comparative studies of U-VATS and M-VATS anatomical pulmonary resection for NSCLC. Operative time, blood loss, number of resected lymph nodes, drainage duration, length of postoperative stay, pain in postoperative day 1(POD1) and conversion rates were retrieved to estimate the comparison of outcomes. A subgroup analysis stratified by study type (propensity-matched analysis and randomized-controlled trial versus non-propensity matched analysis) was performed. RESULT:A total of 20 studies with 4142 patients were included in this meta-analysis. U-VATS was performed on 1869 patients, whereas the other 2173 patients underwent M-VATS. This meta-analysis showed that there was no significant difference in operative time (U-VATS: 146.48?±?55.07?min versus M-VATS: 171.70?±?79.40?min, P?=?0.81), blood loss (74.49?±?109.03?mL versus 95.48?±?133.67?mL, P?=?0.18), resected lymph nodes (17.28?±?9.46 versus 18.31?±?10.17, P?=?0.62), conversion rate (6.18% versus 4.34%, P?=?0.14), drainage duration (3.90?±?2.94?days versus 4.44?±?3.12?days, p?=?0.09), length of postoperative stay (6.16?±?4.40?days versus 6.45?±?4.80?days, P?=?0.22), and pain in POD1 (3.94?±?1.68 versus 3.59?±?2.76, p?=?0.07). Subgroup analysis showed the value of PSM and RCT group consistency with overall value. CONCLUSION:This up-to-date meta-analysis shows that the perioperative outcomes of U-VATS and M-VATS anatomical pulmonary resection are equivalent. In addition, the differences in long-term outcomes of these two approaches are still unclear. Thoracic surgeons should pay more emphasize on providing high-quality and personalized surgical care for patients, to improve the survival ultimately.

Dataset Information

Image-guided video-assisted thoracoscopic resection (iVATS): Translation to clinical practice-real-world experience.

Publications

Image-guided video-assisted thoracoscopic resection (iVATS): Translation to clinical practice-real-world experience.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure