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Surgeon experience influence lymphadenectomy during VATS lobectomy: National VATS database results.
Chiappetta, Marco; Sassorossi, Carolina; Lococo, Filippo; Curcio, Carlo; Crisci, Roberto; Sperduti, Isabella; Meacci, Elisa; Margaritora, Stefano.
Afiliação
  • Chiappetta M; Università Cattolica del Sacro Cuore, Rome, Italy; Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Electronic address: marcokiaps@hotmail.it.
  • Sassorossi C; Università Cattolica del Sacro Cuore, Rome, Italy; Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Lococo F; Università Cattolica del Sacro Cuore, Rome, Italy; Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Curcio C; Thoracic Surgery Unit, Division of Thoracic Surgery, Monaldi Hospital, Naples, Italy.
  • Crisci R; Department of Thoracic Surgery, University of L'Aquila, L'Aquila, Italy.
  • Sperduti I; Biostatistics, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • Meacci E; Università Cattolica del Sacro Cuore, Rome, Italy; Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Margaritora S; Università Cattolica del Sacro Cuore, Rome, Italy; Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Eur J Surg Oncol ; 50(4): 108054, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38457859
ABSTRACT

OBJECTIVES:

Aim of this study is to identify the factors that may influence the lymphadenectomy during VATS anatomical lung resection with particular interest on operator experience. MATERIALS AND

METHODS:

Clinical and pathological data from the prospective VATS Italian nationwide registry were reviewed and analysed. Patients with incomplete data regarding tumor and surgical characteristics, GGO, or with distant metastases were excluded. Patients clinical data, tumor characteristics, operation information and surgeon experience were collected and compared to resected lymph nodes number (#RN), resected N2 nodes number (#N2RN) and resected N2 stations number. A multivariable model was built using logistic regression analysis. Surgeon experience was categorized considering the number of VATS major anatomical resection and years after residency.

RESULTS:

The final analysis was conducted on 3727 patients. The median #RN and #N2RN were 11 (1-51) and 5 (0-41). Regarding the analysed outcomes, #N2RN > 6 resulted in 1812 (48.8%)cases, #RN > 10 in 2124 (57.0%)cases and more than 3 N2 stations were harvested in 1447 (38.8%)patients. First operator experience with number of VATS lobectomies>50 (p < 0.001), operator seniority after residency5-10years (p < 0.001), cTNM II/III(p = 0.017), lobectomy/bilobectomy vs segmentectomy (p < 0.001), and upper/middle lobe tumor location (p < 0.005)resulted significantly associated to #N2RN > 6 at the multivariable analysis. First operator experience with number of VATS lobectomies>50 (p < 0.001), operator seniority after residency5-10years (p < 0.001) and lobectomy/bilobectomy (p < 0.001) resulted significantly associated to #RN > 10 at the multivariable analysis.

CONCLUSIONS:

Our study showed that lymphadenectomy during VATS lobectomy is influenced by tumor factors such as cTstage and tumor location but also by operator experience, with a higher number of resected lymph nodes in surgeons with a high number of VATS procedures and years after residency compared to surgeons with less experience.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Cirurgiões / Neoplasias Pulmonares Limite: Humans Idioma: En Revista: Eur J Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Cirurgiões / Neoplasias Pulmonares Limite: Humans Idioma: En Revista: Eur J Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2024 Tipo de documento: Article