PMD38 THE CLINICAL AND ECONOMIC ANALYSES OF VIDEO ASSISTED THORACOSCOPIC SURGERY FOR LOBECTOMY: EXPERIENCE FROM A TOP ACADEMIC MEDICAL CENTER IN CHINA

Abstract

Pulmonary lobectomy remains the most commonly performed operation in general thoracic surgery practice. The video assisted thoracoscopic surgery (VATS) for lobectomy which is newly developed technology represents an important option for lung cancer due to less morbidity and mortality compare with open lobectomy. This study aims to investigate the economic and clinical outcomes of VATS lobectomy versus open lobectomy in Chinese real-world setting. A retrospective cohort analysis was conducted using the hospital EMR database of the first affiliated hospital of University of Science and Technology of China. The patient inclusion criteria were specified: 1) hospitalized in thoracic surgery department between 2016 and 2017; 2) performed open lobectomy (116 patients) or VATS lobectomy (710 patients). The primary endpoint was length of stay (LOS), operation time, and interoperative blood loss, along with total hospitalization cost, cost breakdowns, hemorrhage volume and re-operation rate as the exploratory outcomes. Where applicable, t-test and the Kruskal-Wallis test for continuous variables and the Chi-Square test for categorical variables would be determined if the different groups are significant. There were no statistically differences in baseline characteristics. Compared with open lobectomy group, VATS group has shorter LOS (12.26 vs. 15.27, P＜0.001) and less interoperative blood loss (91.15 vs. 255.6, P＜0.001), while its operation time were no statistical significance. Although the total hospitalization costs were similar, CNY46,799.70 in VATS lobectomy group vs CNY45,321.98 in open group (P=0.478), the proportion of material cost in VATS was higher (44% vs. 37%, P＜0.001). Besides, VATS group was associated with significantly less hemorrhage volume, and similar re-operation rate. The VATS lobectomy shows benefits in LOS and interoperative blood loss compare to open lobectomy. Meanwhile, although the consumable material cost proportion is higher in VATS group, the total hospitalization cost will not increase due to cost-savings in medicine and treatment costs.