• Benoît Bédat, Etienne Abdelnour-Berchtold, Thomas Perneger, Marc-Joseph Licker, Alexandra Stefani, Matthieu Krull, Jean Yannis Perentes, Thorsten Krueger, Frédéric Triponez, Wolfram Karenovics, and Michel Gonzalez.
• Division of Thoracic and Endocrine Surgery, University Hospitals of Geneva, Geneva, Switzerland. benoit.bedat@hcuge.ch.
• J Cardiothorac Surg. 2019 Nov 7; 14 (1): 189.

BackgroundCompared to lobectomy by video-assisted thoracic surgery (VATS), segmentectomy by VATS has a potential higher risk of postoperative atelectasis and air leakage. We compared postoperative complications between these two procedures, and analyzed their risk factors.MethodsWe reviewed the records of all patients who underwent anatomical pulmonary resections by VATS from January 2014 to March 2018 in two Swiss university hospitals. All complications were reported. A logistic regression model was used to compare the risks of complications for the two interventions. Adjustment for patient characteristics was performed using a propensity score, and by including risk factors separately.ResultsAmong 690 patients reviewed, the major indication for lung resection was primary lung cancer (86.4%) followed by metastasis resection (5.8%), benign lesion (3.9%), infection (3.2%) and emphysema (0.7%). Postoperatively, there were 80 instances (33.3%) of complications in 240 segmentectomies, and 171 instances (38.0%) of complications in 450 lobectomies (P = 0.73). After adjustment for the patient's propensity to be treated by segmentectomy rather than lobectomy, the risks of a complication remained comparable for the two techniques (odds ratio for segmentectomy 0.91 (0.61-1.30), p = 0.59). Length of hospital stay and drainage duration were shorter after segmentectomy. On multivariate analysis, an American Society of Anesthesiologists score above 2 and a forced expiratory volume in one second below 80% of predicted value were significantly associated with the occurrence of complications.ConclusionsThe rate of complications and their grade were similar between segmentectomy and lobectomy by VATS.

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