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P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P1.02-017 - Complications after Lobectomy or Segmentectomy for cT1aN0M0 Non-Small Cell Lung Cancer (ID 540)
09:30 - 17:00 | Author(s): Y. Sugiura
Although lobectomy is considered the standard surgical approach for clinical T1aN0M0 non-small cell lung cancer (NSCLC), several recent studies have shown segmentectomy could be a substitute for lobectomy for early stage NSCLC. However, the differences of perioperative complications between lobectomy and segmentectomy have not yet been fully evaluated. The aim of this study is to investigate the postoperative complications which occurred after lobectomy or segmentectomy using propensity-matched analysis.
Between February 2006 and February 2013, 100 patients underwent lobectomy and 111 patients underwent segmentectomy for clinical T1aN0M0 NSCLC. A retrospective comparison with each group was performed in perioperative mortality, morbidity, operative time, blood loss, length of hospital stay, chest tube duration and clinical parameters including age, gender, preoperative forced expiratory volume in 1 second percentage predicted (preop FEV1%), and Charlson Comorbidity Index (CCI). Data was analyzed for all patients and their propensity score matched pairs.
The rate of postoperative complications in the segmentectomy group (n = 21, 19%) was significantly higher than that in the lobectomy group (n = 7, 7%) (p < 0.01). The majority of complications were prolonged air leak. There was no significant difference in postoperative length of hopital stay and chest tube duration.The average operative time of 263 ± 64 minutes and estimated blood loss of 133 ± 125 ml for segmentectomy were significantly more than those of lobectomy (201 ± 61 minutes and 88 ± 101ml, respectively). In propensity score matched analysis (61 patients each), the average operative time of 270 ± 70 minutes for segmentectomy was longer than that of lobectomy (202 ± 67 minutes). Postoperative complications were more frequent in the segmentectomy group than those in lobectomy group (19.6% and 6.5%, p = 0.03).
Although segmentectomy could offer preservation of pulmonary function, significantly more postoperative complications occurred in the segmentectomy group compared with lobectomy group. The majority of complications were prolonged air leaks in all patients and propensity matched pairs. The operation time was also longer in the segmentectomy group. Surgeons should bear in mind that complications can happen more frequently after segmentectomy than after lobectomy for cT1aN0M0 NSCLC.
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