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MIS, Video-Assisted Thoracoscopic Lobectomies For Lung Cancer Better Than Open Surgery

Wed, 05/09/2012 - 8:01am

/PRNewswire/ -- In a retrospective analysis using the Premier hospital database, the minimally-invasive approach of video-assisted thoracoscopic surgery (VATS) lobectomies for lung cancer indications show both clinical and economic advantages compared to open thoracotomy for lobectomy. Patients undergoing VATS lobectomy had significantly shorter lengths of stay and lower hospital costs than those undergoing the same procedure using an open approach for lung cancer indications. These advantages persisted even after adjusting for potentially important differences in patient and hospital characteristics. The study was accepted for publication in the Annals of Thoracic Surgery, and is currently published in the online edition. The study was funded by Ethicon Endo-Surgery, Inc. (EES), a leading provider of advanced surgical solutions for minimally-invasive and open procedures.

"Although thoracic surgeons have several choices in the approach to diagnose and treat lung cancer, our findings indicate that VATS techniques provide better patient outcomes compared with open surgery. As a result of better outcomes for patients - less complications and shorter length of stay - the hospital cost is significantly less," said Dr. Scott Swanson, Division of Thoracic Surgery, Brigham and Women's Hospital and the Dana Farber Cancer Institute, Boston. "We believe this evidence will help increase the adoption of VATS procedures for lung cancer indications."

The study, entitled "Video-Assisted Thoracoscopic Lobectomy Is Less Costly and Morbid Than Open Lobectomy: A Retrospective Multi-Institutional Database Analysis*," was authored by Scott J. Swanson, MD(i); Bryan F. Meyers, MD(ii); Candace L. Gunnarsson, EdD(iii); Matthew Moore, MHA, Ethicon Endo-Surgery, Inc.(iv); John A. Howington, MD(v); Michael A. Maddaus, MD(vi); Robert J. McKenna, MD(vii); and Daniel L. Miller, MD(viii). The investigators assessed and compared the safety, utilization and cost profiles of VATS versus open thoracotomy for lobectomy in lung cancer among thoracic surgeons.

The study utilized the Premier hospital database as the data source; it contains clinical and utilization information on patients receiving care in more than 600 U.S. hospitals across the nation. The data also revealed that VATS lobectomies for lung cancer indications are performed in approximately half of all hospitals and one quarter of all patients undergoing lobectomy for lung cancer.

Of 8,228 patients in the database with elective, inpatient lung resections of any kind for lung cancer, a total of 3,961 patients underwent lobectomy by a thoracic surgeon using open thoracotomy (n=2,907) or VATS (n=1,054).

Overall, hospital costs were significantly higher for open lobectomy than for VATS: $21,016 versus $20,316 (p=0.027). The same was true for length of stay: 7.83 days vs. 6.15 days (p<0.006), for open versus VATS. The risk of patients needing prolonged hospital stays (> or = 14 days) also was significantly greater in the open lobectomy group than in the VATS lobectomy group. Conversely, surgery time remained significantly shorter for open lobectomy at 3.75 hours vs. 4.09 hours for VATS lobectomy (p=0.00).

"EES is committed to educating patients and providers about the clinical and economic benefits of minimally invasive surgery, including VATS lobectomy for lung cancer indications," said Matt Moore, director of Reimbursement and Healthcare Economics at EES.

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