Original articleGeneral thoracicOpen, Video-Assisted Thoracic Surgery, and Robotic Lobectomy: Review of a National Database
Section snippets
Data Source
The SID are a family of datasets developed by the Healthcare Cost and Utilization Project (HCUP), and have been maintained by the Agency for Healthcare Research and Quality since 1995 [14]. The SID captures approximately 90% of all discharges within a given state, and contains a core set of clinical and nonclinical information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. More than 100 clinical and nonclinical
Trends in Use of VATS and Robotic Surgery
Over the 3-year period, 33,095 patients underwent a lobectomy or segmentectomy (Fig 1). Overall 430 cases (1.3%) were performed robotically. However, case volume for robotic resections increased over the study period, from 0.2% of cases in 2008 to 3.4% of cases in 2010. In addition, the proportion of cases performed through thoracotomy declined over the study period, from 66.3% in 2008 to 56.6% in 2010.
Hospital and Surgeon Characteristics
Pulmonary resections were performed in 711 hospitals in this dataset. A total of 37 centers
Comment
In this study the majority of cases were performed using an open approach, a finding consistent with prior publications using similar datasets 1, 20. Robotic pulmonary resections represented only 1.3% of all cases. However, robotic surgery was performed in all 8 states in the time period studied, and utilization increased significantly from 2008 (0.2% of all cases) to 2010 (3.4% of cases).
As shown in prior publications [21], VATS resections were associated with decreased mortality, rate of
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RoboticAssisted (RATS) versus Video-Assisted (VATS) lobectomy: A monocentric prospective randomized trial
2023, European Journal of Surgical OncologyGenerating Rare Surgical Events Using CycleGAN: Addressing Lack of Data for Artificial Intelligence Event Recognition
2023, Journal of Surgical ResearchCitation Excerpt :In a study by Gonzalez-Rivas et al., it is suggested that the main causes of bleeding during VATS lobectomy resulted from surgeon inexperience, iatrogenic injury difficulty during vascular dissection or instrumentation, and calcified or malignant hilar lymph nodes.6 However, with adequate training and experience, intraoperative bleeding from VATS has reported to become as low as 1.3%.7 Given the overall low incidence, it can be a challenge to train surgeons on best means to address massive intraoperative bleeding when it occurs as the exposure is limited by nature.
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Both authors contributed equally to this study.