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This study investigates the most common major complications that result in unplanned additional surgery in patients undergoing vats anatomical resections. Several high-volume European centres participate. The purpose is to quantify these major complications, discuss the steps that can be taken to prevent these events, how they can be dealt with, be it by vats or conversion
Vats lobectomy is becoming the standard of care for early stage lung cancer. Several studies have shown feasibility and safety in dedicated centres. Compared to thoracotomy the procedure results in at least equal oncologic results and survival, perhaps better.
Most series do not publish their early experience. They are retrospective and report on lobectomies and segmentectomies, excluding the live-saving pneumonectomies. They are potentially ignoring the intention-to-treat principle, excluding conversions.
Based on scarce existing literature and conference worst-case presentations a pattern of the most common intraoperative major complications can be drawn In Europe, a large percentage of high-volume-centres have now successfully implemented a vats lobectomy program. In this era with low-volume-centres switching into vats anatomical resections, it is important to focus on potentially life-threatening complications. To be aware of potential hazards is the best way to avoid them.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No additional unplanned major surgery | uneventfull intra-operative and postoperative course | ||
| Additional unplanned major surgery | Additional per-operative or post-operative unplanned major surgery such as unforeseen pneumonectomy, bilobectomy, lobectomy or additional segmentectomy, repair of major vessels or bronchi, bronchopleural fistula, unplanned surgery to other organs, within 30 days after the primary surgery. These do not include:
|
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| Measure | Description | Time Frame |
|---|---|---|
| additional unplanned major surgery | the percentage of major complications that resulted in additional unplanned major surgery during vats anatomical resection or at revision within 30 days. | during vats anatomical resection or at revision within 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| number of conversions to open surgery | The number of VATS procedures that need conversion to open surgery because of major complications or unplanned major surgery | during VATS procedure |
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Inclusion Criteria:
Exclusion Criteria:
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All patients intended to undergo a vats anatomical resection
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| Name | Affiliation | Role |
|---|---|---|
| Herbert Dacaluwé, MD | Universitaire Ziekenhuizen KU Leuven | Principal Investigator |
| Dominique Gossot, MD | Thoracic Department, Institut Mutualiste Montsouris, 42 Bd Jourdan, F-75014 Paris, France | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Visceral, Transplant and Thoracic Surgery, Innsbruck University Hospital | Innsbruck | Austria | ||||
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| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Department of Cardiothoracic Surgery, Rigshospitalet |
| Copenhagen |
| Denmark |
| Thoracic Department, Institut Mutualiste Montsouris | Paris | F-75014 | France |
| Katholisches Klinikum, Thoraxchirurgie | Koblenz | Germany |
| Division of Thoracic Surgery, Ospedali Riuniti Ancona | Ancona | 60020 | Italy |
| Maatschap Heelkunde Zuid-Limburg | Heerlen | Netherlands |
| Karol Marcinkowski University of Med Sciences, Department of Thoracic Surgery | Poznan | Poland |
| Department of Thoracic Surgery | A Coruña | Spain |
| UniversitätsSpital Zürich | Zurich | Switzerland |
| D008171 |
| Lung Diseases |
| D012140 | Respiratory Tract Diseases |