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Felipe Braga



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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): Felipe Braga

      • Abstract
      • Slides

      Background

      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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