Promising Short-Term Outcomes of Pulmonary Resections from Low-Volume Centre in Tier II City in India

TL;DR

The study shows that lung cancer surgeries in a low-volume center in India can have safe short-term outcomes with proper patient selection and skilled teams.

Contribution

It demonstrates successful pulmonary resections in a low-volume center in a Tier II city, challenging assumptions about resource limitations.

Findings

No 30-day mortality was observed among 12 patients undergoing lung resections.

Major complications like air leak and collapse occurred in 33.3% of patients.

Median hospital stay was 6.5 days, indicating relatively efficient recovery.

Abstract

Lung cancer is one of the leading causes of cancer-related deaths in the world. Surgery offers the best potential cure, but as in any surgery, there are some complications that will be minimised with the improvement of surgical practice and treatment protocols. This study aims to analyse the short-term outcomes of thoracoscopic and open lung resections in a low volume centre at Visakhapatnam, India. Twelve patients who underwent thoracoscopic or open lung resections for primary and metastatic lung tumors from September 2022 to December 2023 at Homi Bhabha Cancer Hospital & Research Centre (HBCH&RC), Visakhapatnam, were analysed retrospectively. Data was collected from Electronic Medical Records including demographic data, neo-adjuvant and adjuvant therapy, surgical procedure performed, histopathology type, time to chest drain removal, length of hospital stay, perioperative mortality and morbidity occurring within 30 days after surgery. Statistical analysis was performed using SPSS version 26. A total 12 patients underwent pulmonary resections during the study period. Median age was 48.5 years. Surgical procedures performed were 4-bilobectomies, 7-lobectomies and 1-metastasectomy. Chest wall resection was performed for 2 cases, pericardial and diaphragm excision for one case. Surgical approaches were video-assisted thoracoscopic surgery (VATS), VATS converted to open and open—4 each. Major common complications were air leak and collapse which occurred in 33.3% of patients. Median duration of hospital stay was 6.5 days. There was no 30-day mortality. Safe outcomes are achievable after lung resections (both open and VATS procedures) in low-volume centre with trained and dedicated surgeons, anaesthesiologists and proper patient selection.