ArticleJournal of thoracic disease2021
Estimating the risk of conversion from video-assisted thoracoscopic lung surgery to thoracotomy-a systematic review and meta-analysis.
Article in Journal of thoracic disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 22 citations in OpenAlex.
- Impact of modern minimally invasive approaches on pulmonary resection outcomes: a narrative review.Journal of thoracic disease · 2026Review
- Intraoperative assessment of pulmonary fissure morphology in a large surgical series: implications for operative strategy.General thoracic and cardiovascular surgery · 2026Article
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- Translational development of an SGLT2-targeted near-infrared contrast agent for intraoperative imaging of early-stage lung cancer.EJNMMI research · 2026Article
- Thoracoscopic lobectomy for early-stage non-small cell lung carcinoma: initial experience from a newly established Israeli center.Journal of thoracic disease · 2026Article
- Perioperative outcomes of uniportal video-assisted thoracoscopic lobectomy in scope operation performed by a clinical engineer.Journal of thoracic disease · 2025Article
- Article
- Spot On: Indocyanine Green-Soaked Fiducial Markers for Lung Nodules Prior to Thoracic Surgery.CHEST pulmonary · 2025Article
- Techniques of double-sleeve lobectomy for lung cancer: a narrative review of clinical practice.Journal of visualized surgery · 2025Review
- Development of a Risk Scoring Model to Predict Unexpected Conversion to Thoracotomy during Video-Assisted Thoracoscopic Surgery for Lung Cancer.Journal of chest surgery · 2024Article
- N1-positive non-small cell lung cancer: surgeons' perspective before undertaking a major resection.Indian journal of thoracic and cardiovascular surgery · 2024Review
- Spontaneous Ventilation Combined with Double-Lumen Tube Intubation during Thoracic Surgery: A New Anesthesiologic Method Based on 141 Cases over Three Years.Journal of clinical medicine · 2023Article
- Article
- The detailed classification of the interlobar artery and the artery crossing intersegmental planes in the right upper lobe.Frontiers in oncology · 2023Article
- Anatomical analysis of variations in the bronchus pattern of the left upper lobe using three-dimensional computed tomography angiography and bronchography.Annals of translational medicine · 2022Article
- Prevention of intraoperative bleeding during thoracoscopic left lower lobectomy; an unnecessary occlusion of pulmonary artery and vein.Annals of thoracic medicineArticle
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding the risk of conversion from video-assisted thoracic surgery (VATS) to thoracotomy is important when considering patient selection and preoperative surgical risk assessment. This review aims to estimate the rate of intraoperative conversions to thoracotomy, predictive factors, and associated outcomes for VATS anatomic lung resections.
methodsPubMed/MEDLINE and EMBASE were searched systematically in May of 2020. Observational studies examining conversions of VATS anatomic resections to thoracotomy were included. Conversion rates, causes, risk factors, and post-operative outcomes were reviewed and analyzed in aggregate.
resultsTwenty retrospective studies were reviewed, with a total of 72,932 patients undergoing VATS anatomic lung resection. The median conversion rate was 9.6% (95% CI: 6.6-13.9%). Nine studies reported a total of 114 emergency conversions, with a median incidence rate of 1.3% (95% CI: 0.6-2.8%). The most common reasons for thoracotomy were vascular injury/bleeding, difficulty lymph node dissection, and adhesions, accounting for 27.9%, 26.2% and 19% of conversions, respectively. Risk factors for conversion varied, but frequently included nodal disease, large tumors, and induction therapy. The risk of complications (OR 2.06; 95% CI: 1.77-2.40) and mortality (OR 4.11; 95% CI: 1.59-10.61) were significantly increased following conversions. There was also a significant increase in chest tube duration and length of stay following conversion.
conclusionsThe risk of conversion to thoracotomy may be as high as one in ten patients undergoing VATS anatomic lung resections, but may vary significantly based on patient selection. Although emergent conversions are rare, the need for thoracotomy may significantly increase postoperative morbidity and mortality.
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