TY - JOUR
T1 - Safety and efficacy of median sternotomy versus video-assisted thoracic surgery for lung volume reduction surgery
AU - National Emphysema Treatment Trial Research Group
AU - Fishman, Alfred P.
AU - Bozzarello, Betsy Ann
AU - Al-Amin, Ameena
AU - Katz, Marcia
AU - Wheeler, Carolyn
AU - Baker, Elaine
AU - Barnard, Peter
AU - Cagle, Phil
AU - Carter, James
AU - Chatziioannou, Sophia
AU - Conejo-Gonzales, Karla
AU - Dubose, Kimberly
AU - Haddad, John
AU - Hicks, David
AU - Kleiman, Neal
AU - Milburn-Barnes, Mary
AU - Nguyen, Chinh
AU - Reardon, Michael
AU - Reeves-Viets, Joseph
AU - Sax, Steven
AU - Sharafkhaneh, Amir
AU - Wilson, Owen
AU - Young, Christine
AU - Espada, Rafael
AU - Butanda, Rose
AU - Ellisor, Minnie
AU - Fox, Pamela
AU - Hale, Katherine
AU - Hood, Everett
AU - Jahn, Amy
AU - Jhingran, Satish
AU - King, Karen
AU - Miller, Charles
AU - Nizami, Imran
AU - Officer, Todd
AU - Ricketts, Jeannie
AU - Rodarte, Joe
AU - Teague, Robert
AU - Williams, Kedren
AU - Reilly, John
AU - Sugarbaker, David
AU - Fanning, Carol
AU - Body, Simon
AU - Duffy, Sabine
AU - Formanek, Vladmir
AU - Fuhlbrigge, Anne
AU - Hartigan, Philip
AU - Hooper, Sarah
AU - Hunsaker, Andetta
AU - Bartels, Matthew
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2004/1/1
Y1 - 2004/1/1
N2 - Background: The National Emphysema Treatment Trial, a randomized trial comparing lung volume reduction surgery with medical therapy for severe emphysema, included randomized and nonrandomized comparisons of the median sternotomy and video-assisted thoracoscopic approaches for lung volume reduction surgery. Methods: Lung volume reduction surgery was performed by median sternotomy only at 8 centers and video-assisted thoracoscopy only at 3 centers; 6 centers randomized the approach to lung volume reduction surgery. Mortality, morbidity, functional status, and costs were assessed. Results: In the nonrandomized comparison, 359 patients received lung volume reduction surgery by median sternotomy, and 152 patients received lung volume reduction surgery by video-assisted thoracoscopy. The 90-day mortality was 5.9% for median sternotomy and 4.6% for video-assisted thoracoscopy (P = .67). Overall mortality was 0.08 deaths per person-year for median sternotomy and 0.10 deaths per person-year for video-assisted thoracoscopy (video-assisted thoracoscopy-median sternotomy risk ratio, 1.18; P = .42). Complication rates were low and not statistically different for the 2 approaches. The median hospital length of stay was longer for median sternotomy than for video-assisted thoracoscopy (10 vs 9 days; P = .01). By 30 days after surgery, 70.5% of median sternotomy patients and 80.9% of video-assisted thoracoscopy patients were living independently (P = .02). Functional outcomes were similar for median sternotomy and video-assisted thoracoscopy at 12 and 24 months. Costs for the operation and the associated hospital stay and costs in the 6 months after surgery were both less for video-assisted thoracoscopy than for median sternotomy (P < .01 in both cases). Similar results were noted for the randomized comparison. Conclusions: Morbidity and mortality were comparable after lung volume reduction surgery by video-assisted thoracoscopy or median sternotomy, as were functional results. The video-assisted thoracoscopic approach to lung volume reduction surgery allowed earlier recovery at a lower cost than median sternotomy.
AB - Background: The National Emphysema Treatment Trial, a randomized trial comparing lung volume reduction surgery with medical therapy for severe emphysema, included randomized and nonrandomized comparisons of the median sternotomy and video-assisted thoracoscopic approaches for lung volume reduction surgery. Methods: Lung volume reduction surgery was performed by median sternotomy only at 8 centers and video-assisted thoracoscopy only at 3 centers; 6 centers randomized the approach to lung volume reduction surgery. Mortality, morbidity, functional status, and costs were assessed. Results: In the nonrandomized comparison, 359 patients received lung volume reduction surgery by median sternotomy, and 152 patients received lung volume reduction surgery by video-assisted thoracoscopy. The 90-day mortality was 5.9% for median sternotomy and 4.6% for video-assisted thoracoscopy (P = .67). Overall mortality was 0.08 deaths per person-year for median sternotomy and 0.10 deaths per person-year for video-assisted thoracoscopy (video-assisted thoracoscopy-median sternotomy risk ratio, 1.18; P = .42). Complication rates were low and not statistically different for the 2 approaches. The median hospital length of stay was longer for median sternotomy than for video-assisted thoracoscopy (10 vs 9 days; P = .01). By 30 days after surgery, 70.5% of median sternotomy patients and 80.9% of video-assisted thoracoscopy patients were living independently (P = .02). Functional outcomes were similar for median sternotomy and video-assisted thoracoscopy at 12 and 24 months. Costs for the operation and the associated hospital stay and costs in the 6 months after surgery were both less for video-assisted thoracoscopy than for median sternotomy (P < .01 in both cases). Similar results were noted for the randomized comparison. Conclusions: Morbidity and mortality were comparable after lung volume reduction surgery by video-assisted thoracoscopy or median sternotomy, as were functional results. The video-assisted thoracoscopic approach to lung volume reduction surgery allowed earlier recovery at a lower cost than median sternotomy.
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U2 - 10.1016/j.jtcvs.2003.11.025
DO - 10.1016/j.jtcvs.2003.11.025
M3 - Article
C2 - 15115992
AN - SCOPUS:2342429980
VL - 127
SP - 1350
EP - 1360
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 5
ER -