Discharge independence with minimally invasive lobectomy

Background: The effects of video-assisted thoracic surgery (VATS) pulmonary lobectomy on after-hospital care are not well known. Methods: In a retrospective case-control study, 20 consecutive VATS cases were matched to 38 standard thoracotomies (open cases). Results: Ages were 73.8 +/- 7.8 years with no-initial differences between the groups. No hospital deaths occurred. Excluding 2 VATS and 6 open outliers, VATS cases had fewer hospital days (4.6 +/- 1.9 vs. 6.4 +/- 2.2, P < 0.01), chest tube days (3.0 +/- 1.1 vs. 4.2 +/- 1.7, P 0.01), and prolonged pain complaints (28% vs. 56%, P = 0.05). Transfer to care facilities or home nursing support was needed for 63% of open patients and only 20% of VATS patients (P = 0.615). Less, personal care (10% vs. 21%), wound/medical care (0% vs. 13%), occupational/physical therapy (5% vs. 13%), or other home support (5% vs. 18%) was needed for VATS patients. Conclusions: In older populations, more independence and fewer resources after discharge favor VATS lobectomy over standard thoracotomy. (C) 2004 Excerpta Medica Inc. All rights reserved.