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Date Published: 03/11/2020
Online Published: 03/11/2020
Abstract Views: 194
Views PDF: 128
DOI: https://doi.org/10.47972/vjcts.v7i.247
Issue
Vol. 7
Section
Research Article
How to Cite
Khanh, H. Q. ., Vinh, V. H. ., Anh, P. M. ., & Nam, N. H. (2020). A COMPARISON OF PERIOPERATIVE OUTCOMES OF VIDEO-THORACIC SURGICALRESECTIONOF PRIMARY MEDIASTINAL TUMORS WITH OPEN METHOD: RESULTS OF AN ANALYSIS USING PROPENSITY SCORE BASED WEIGHTING. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 7, 39-50. https://doi.org/10.47972/vjcts.v7i.247

A COMPARISON OF PERIOPERATIVE OUTCOMES OF VIDEO-THORACIC SURGICALRESECTIONOF PRIMARY MEDIASTINAL TUMORS WITH OPEN METHOD: RESULTS OF AN ANALYSIS USING PROPENSITY SCORE BASED WEIGHTING

Huynh Quang Khanh, Vu Huu Vinh, Pham Minh Anh, Nguyen Hoai Nam

Main Article Content

Abstract

Background:Randomized trials comparing VATS mediastinal tumors resection to open method are very few. We analyzed a cohort using propensity scoreweighting to adjust for important covariates in order to compare the clinical outcomes of the two techniques. *
Methods: a prospective cohort two group VTS and Open. From July 2010 to July 2013 at Thoracic Surgery Department Cho Ray hospital.We compared patients undergoing mediastinal tumors resection for benign tumors or early clinical stage by either VTS or open methods. Inverse probability of treatment weighted estimators, with weights derived from propensity scores, was used to adjust cohorts for determinants of perioperative morbidity and mortality including age, gender, tumors size, ASA class, and Charlson Comorbidity Index (CCI). Bootstrap methods provided standard errors. Endpoints were operative time, blood loss, postoperative stay (LOS), chest tube duration, postoperative pain score, complications.


Results:We analyzed 209 patients with mediastinal tumors resection. None of operative mortality observed or none of VTS was converted to open procedures. Adjusted median operative time (min) was 128,9 (OPEN) versus 75,8 (VTS), P < 0,0001. Adjusted median blood loss (ml) 253,3 (OPEN) versus 65,2 (VTS), P < 0,0001. Adjusted median LOS was 7,8 days (OPEN) versus 5,4 days (VTS), P < 0.0001. Adjusted median chest tube duration (days) was 3,1 (OPEN) versus 2,1 (VTS), P < 0.0001. Adjusted median pain score postoperative was 6,6 (OPEN) versus 4,5 (VTS), P <0,0001. Complication rates were 6,7% (OPEN) versus 0,9% (VTS), P = 0.011.
Conclusions: After balancing covariates that affect morbidity, mortality and LOS in this cohort using propensity-weighting, the resultsconfirm that VTS mediastinal tumors resection is associated with a statistically significantshorter operative time, less blood loss, shorter LOS, shorter chest tube duration, lesspostoperative pain score than in OPEN group. No mortality in two groups. Complication rates are lessin VTS than in OPEN group.

Article Details

Keywords

mediastinal tumors, video thoracoscopic surgery-VTS, VATS, PS Matching.

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