Lung cancer: VATS, robotic surgery yield fewer readmissions

  • Bailey KL & al.
  • World J Surg
  • 2 Jan 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Video-assisted thoracoscopic (VATS) and robotic lobectomies offered significantly lower readmission rates compared with open lobectomy, as well as better outcomes, in patients with lung cancer.
  • VATS offered fewer early complications and lower cost vs robotic lobectomy.

Why this matters

  • The association between surgical approach and readmission was unclear.

Study design

  • 129,539 patients from the Nationwide Readmissions Database underwent pulmonary lobectomy between 2010 and 2014.
  • Funding: None disclosed.

Key results

  • 57.5% of cases were open, 37.2% VATS, 5.3% robotic.
  • 10.5% of patients were readmitted within 30 days of index surgery.
  • Open surgery was associated with a significantly higher 30-day readmission rate than VATS and robotic surgery (10.5% vs 9.3%; P<.001>
  • Compared with VATS and robotic groups, the open lobectomy group had higher in-hospital mortality (2.02% vs 1.18%), median costs ($21,846 vs $20,779), and median length of stay (6 vs 4 days; P<.001 for all>
  • Compared with the VATS group, the robotics group had higher median costs ($23,870 vs $20,279; P<.001 discharges home vs p=".006)," and pulmonary complications>
  • Readmission rates, in-hospital mortality, and length of stay were similar between robotic and VATS groups.
  • After multivariable analysis, open lobectomy was an independent predictor of readmission (OR, 1.12; P<.001>

Limitations

  • Retrospective study.