Trends in open lobectomy outcomes for lung cancer over the last 15 years: national cohort

Objective Adoption of thoracoscopic lobectomy has been increasing in the US; however, open lobectomy (OL) is still performed in half of the cases. Postoperative care and enhanced recovery after surgery (ERAS) pathways have evolved and improved outcomes. The study aims to evaluate postoperative outco...

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Published in:General thoracic and cardiovascular surgery 2022-02, Vol.70 (2), p.144-152
Main Authors: Alwatari, Yahya, Scheese, Daniel, Rustom, Salem, Sevdalis, Athanasios E., Ayalew, Dawit, Julliard, Walker, Shah, Rachit D.
Format: Article
Language:English
Subjects:
Aged
Body mass index
Cardiac Surgery
Cardiology
Chronic obstructive pulmonary disease
Cohort Studies
Humans
Length of Stay
Lung cancer
Lung Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Original Article
Pneumonectomy
Postoperative Complications - epidemiology
Retrospective Studies
Surgical Oncology
Thoracic Surgery
Thoracic Surgery, Video-Assisted
Trends
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Summary:Objective Adoption of thoracoscopic lobectomy has been increasing in the US; however, open lobectomy (OL) is still performed in half of the cases. Postoperative care and enhanced recovery after surgery (ERAS) pathways have evolved and improved outcomes. The study aims to evaluate postoperative outcomes of OL over the last 15 years. Methods Patients who underwent lobectomy for lung cancer between 2005 and 2019 were identified in the National Surgical Quality Improvement Program and divided into three groups; pre-ERAS (2005–2011), transitional period (2012–2015), and wider ERAS implementation (2016–2019). Preoperative characteristics and postoperative outcomes were compared and multivariable regression analysis was constructed to assess independent predictors of outcomes. Results OL was comprised of 40% of lobectomies for lung cancer. 10,021 patients met inclusion criteria. 49% were males and mean age was 67. Patients who belonged to the (2016–2019) period group had significantly higher comorbidities and ASA classification. General surgeons performed 
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-021-01703-4