Video-assisted thoracic surgery does not reduce the incidence of postoperative XXXX after pulmonary lobectomy.

@entity1 @entity1149 @entity955
OBJECTIVE: The objective was to define the incidence of @entity955 after video-assisted thoracic surgery lobectomy and determine whether video-assisted thoracic surgery reduces @entity955 rate compared with thoracotomy. METHODS: With the use of a single-institution database of @entity1 who underwent lobectomy for clinical stage I @entity1149 , 389 @entity1 were identified who were in sinus rhythm preoperatively and received no prophylactic antiarrhythmics. @entity1 undergoing video-assisted thoracic surgery were age and gender matched with those undergoing thoracotomy. RESULTS: After matching, 122 @entity1 undergoing video-assisted thoracic surgery and 122 @entity1 undergoing thoracotomy were eligible for analysis. @entity1 undergoing video-assisted thoracic surgery had a higher preoperative diffusion capacity (92% +/- 28% vs 80% +/- 18% predicted, P = .001) and a lower rate of induction chemotherapy (5/122, 4% vs 11/122, 11%, P = .05) than @entity1 undergoing thoracotomy. @entity955 occurred in 12% of @entity1 (15/122) undergoing video-assisted thoracic surgery and 16% of @entity1 (20/122) undergoing thoracotomy (P = .36). Overall, complications were lower in the video-assisted thoracic surgery group (17.2% vs 27.9%, P = .046). @entity1 with @entity955 were older in both video-assisted thoracic surgery (73 +/- 7 years vs 66 +/- 9 years, P = .002) and thoracotomy groups (72 +/- 7 years vs 66 +/- 10 years, P = .005). Length of stay for @entity1 with @entity955 was greater in both video-assisted thoracic surgery (6.0 +/- 1.5 days vs 4.7 +/- 2.5 days, P = .01) and thoracotomy groups (9.2 +/- 4.3 days vs 6.8 +/- 3.6 days, P = .03). CONCLUSIONS: Regardless of surgical approach, @entity955 after lobectomy occurred with equal frequency. This supports the theory that autonomic denervation and stress-mediated neurohumoral mechanisms are responsible for the pathogenesis of postoperative @entity955 . Prophylaxis regimens against @entity955 should be the same for either operative approach.
