Video-assisted thoracoscopic surgery lobectomy at 20 years: A consensus statement

Tristan D. Yan, Christopher Cao, Thomas A. D'amico, Todd L. Demmy, Jianxing He, Henrik Hansen, Scott J. Swanson, William S. Walker*, Gianluca Casali, Joel Dunning, Michael Shackcloth, Rajesh Shah, Sasha Stamenkovic, Tom Routledge, William Walker, Edwin Woo, Steve Woolley, Jean Marc Baste, Dominique Gossot, Giancarlo RoviaroLuciano Solaini, Jesus Loscertales, Diego Gonzalez-rivas, Herbert Decaluwe, Georges Decker, Frederic De Ryck, Youri Sokolow, Jan Wolter Oosterhuis, Jan Siebenga, Thomas Schmid, Johannes Bodner, Henrik Dienemann, Gunda Leschber, Didier Schneiter, Henrik Hansen, Peter Licht, René Horsleben Petersen, Cezary Piwkowski, Tommy D'amico, Todd Demmy, Claude Deschamps, John Howington, Mike Liptay, Robert Mckenna, John Mitchell, Bryan Meyers, Bernard Park, Scott Swanson, Hyun Sung Lee, Jian Xing He, Yun Li, Zhidong Liu, Nan Wu, Anthony Yim, Weicheng Yu, Tadasu Kohno, Gavin Wright

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

170 Citations (Scopus)

Abstract

OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) lobectomy has been gradually accepted as an alternative surgical approach to open thoracotomy for selected patients with non-small-cell lung cancer (NSCLC) over the past 20 years. The aim of this project was to standardize the perioperative management of VATS lobectomy patients through expert consensus and to provide insightful guidance to clinical practice. METHODS: A panel of 55 experts on VATS lobectomy was identified by the Scientific Secretariat and the International Scientific Committee of the '20th Anniversary of VATS Lobectomy Conference-The Consensus Meeting'. The Delphi methodology consisting of two rounds of voting was implemented to facilitate the development of consensus. Results from the second-round voting formed the basis of the current Consensus Statement. Consensus was defined a priori as more than 50% agreement among the panel of experts. Clinical practice was deemed 'recommended' if 50-74% of the experts reached agreement and 'highly recommended' if 75% or more of the experts reached agreement. RESULTS: Fifty VATS lobectomy experts (91%) from 16 countries completed both rounds of standardized questionnaires. No statistically significant differences in the responses between the two rounds of questioning were identified. Consensus was reached on 21 controversial points, outlining the current accepted definition of VATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions. CONCLUSION: The present Consensus Statement represents a collective agreement among 50 international experts to establish a standardized practice of VATS lobectomy for the thoracic surgical community after 20 years of clinical experience.

Original languageEnglish
Article numberezt463
Pages (from-to)633-639
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume45
Issue number4
DOIs
Publication statusPublished - Apr 2014
Externally publishedYes

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