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José Ribas Milanez De-Campos

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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.16-44 - Robotic-Assisted Thoracic Surgery for Early-Stage Non-Small-Cell Lung Cancer: Initial Experience in Brazil (ID 13083)

      12:00 - 13:30  |  Author(s): José Ribas Milanez De-Campos

      • Abstract
      • Slides


      Robotic approach for anatomic lung resection has brought an innovative development in minimally invasive thoracic surgery. The aim of this was to assess the safety and effectiveness of robot-assisted resection in patients with stage I-II non-small-cell lung cancer (NSCLC) in Brazil.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Retrospective analysis of prospectively maintained databases of 2 groups of surgeons from São Paulo and Rio de Janeiro, respectively. We retrieved data regarding demography, diagnosis, operative time, lymphadenectomy, and morbidity of patients undergoing robotic surgery from March-2015 to April-2018. Continuous variables are presented as means and standard deviation. The Shapiro-Wilk test was used for the assessment of normality. Non-parametric data is represented as medians. Categorical variables are presented as absolute numbers and percentage. Alpha error was defined as 5%.

      4c3880bb027f159e801041b1021e88e8 Result

      140 consecutive patients were included (80 Males/60 Females). Mean age was 66 + 9 years old (range:30-85). The majority of patients had adenocarcinoma (n=101;72%), followed by epidermoid (n=29;21%) and carcinoid tumors (n=10;7%). Lobectomy was the most common operation (n=119;85%), followed by anatomic segmentectomies (n=21;15%). Mean overall operative time was 209 + 80 minutes (214 + 80 for lobectomies and 167 + 51 for segmentectomies; p=0.01). Mean number of lymph nodes resected was 12 + 6, and the mean number of lymph nodes stations sampled was 6 + 1. There was no conversion to either VATS or thoracotomy in our series; neither major intraoperative bleeding.

      Postoperative complications occurred in 30 patients (21%). Prolonged air leak was the most common (n=13;9%) and 7 patients were discharged with a chest tube. Chylothorax occurred in 4 patients (2.8%), but all were treated with dietetic measures. Median length-of-stay was 3 days (IQR:2-6).

      The overall 30-day mortality was 0.5% (n=1). One patient had a procedure-related death, 25 days after a lobectomy. He developed pneumonia, sepsis and multiple organ failure. 138 patients (98.5%) are still under follow-up. Disease recurrence occurred in 7.8% of patients (n=11).

      8eea62084ca7e541d918e823422bd82e Conclusion

      Robot-assisted pulmonary resection is safe, effective and provides good outcomes, even within the context of an initial experience. Further follow-up should provide insight regarding long-term oncologic disease control.


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