Table 1:

A univariate analysis of the preoperative characteristics of patients treated with anatomical lung resection with full video-assisted thoracoscopic surgery or intraoperative conversion to thoracotomy

VariableFull VATS group, n = 7100 Conversion group, n = 843 Odds ratio [95% CI]P-value
Sex<0.0001
 Female3032 (42.6 %)289 (34.2 %)1
 Male4068 (57.3%)554 (65.8 %)1.42 [1.25–1.60]
Age (years)69 ± 11.366.0 ± 9.71.012 [1.006–1.018]0.0002
BMI (kg/m²)25.3 ± 4.626.2 ± 5.01.039 [1.026–1.052]<0.0001
WHO PS0.007
 04366 (61.5%)497 (59.0%)1
 12385 (33.6 %)297 (35.5%)1.19 [1.05–1.35]
 2319 (4.5 %)44 (5.2%)1.14 [0.85–1.52]
 328 (0.4%)4 (0.4%)1.93 [0.85–4.38]
 40 (0%)1 (< 0.1%)
ASA status<0.0001
 ASA 1-24785 (67.4%)520 (61.7%)1
 ASA 3-42315 (32.6%)323 (38.3%)1.32 [1.17–1.50]
History of smoking5495 (77.4%)697 (82.6%)1.22 [1.08–1.37]0.001
Smoking (pack-years)30 ± 14.134.4 ± 25.01.005 [1.003–1.008]<0.0001
Preop. FEV190 ± 19.687.7 ± 19.30.993 [0.990–0.996]<0.0001
Induction CTx134 (1.9 %)19 (2.1%)0.809
Hypertension2201 (31 %)293 (34.8%)1.19 [1.05–1.35]0.007
Pulmonary hypertension7 (< 0.1 %)1 (< 0.1%)0.275
Congestive heart failure28 (0.4 %)6 (0.7%)0.791
Peripheral arterial disease646 (9.1 %)110 (13.1%)1.37 [1.14–1.64]0.001
Valvulopathy78 (1.1 %)14 (1.7%)1.74 [1.04–2.90]0.034
Coronary artery disease646 (9.1 %)107 (12.7%)1.34 [1.11–1.63]0.003
Cardiac arrhythmia475 (6.7 %)76 (9.1%)1.31 [1.04–1.64]0.022
Previous cardiac surgery85 (1.2 %)18 (2.2%)1.75 [1.14–2.70]0.011
Stroke244 (3.3 %)39 (4.6%)1.40 [1.04–1.88]0.025
Antiplatelet therapy320 (4.5 %)53 (6.3%)1.45 [1.12–1.87]0.005
Asthma128 (1.8 %)22 (2.5%)0.220
Sleep apnoea198 (2.8 %)26 (3.1%)0.674
Previous thoracic surgery142 (2.0 %)20 (2.4%)1.12 [0.77–1.63]0.541
Previous thoracic trauma7 (< 0.1 %)6 (0.7%)3.34 [1.39–8]0.007
Alcohol addiction334 (4.7 %)47 (5.6%)0.826
Chronic kidney failure134 (1.9%)33 (3.9%)2.32 [1.70–3.17]<0.0001
Malnutrition45 (0.6%)7 (0.9%)0.597
Thyroid dysfunction270 (3.8 %)34 (4.1%)0.295
Drug addiction45 (0.6 %)12 (1.4%)1.55 [0.81–2.94]0.186
Chronic liver failure41 (0.6 %)7 (0.8%)0.527
Type II diabetes724 (10.2 %)130 (15.4%)1.42 [1.19–1.69]<0.0001
Histological analysis<0.0001
 Primary lung6688 (94.2 %)811 (96.2%)1
 Metastasis292 (4.1 %)24 (2.9%)0.63 [0.48–0.83]
 Benign120 (1.7 %)8 (0.9%)0.40 [0.23–0.69]
Surgery side
 Right3684 (51.9%)423 (50.2%)0.257
 Left3416 (48.1%)420 (49.8%)
Extent of resection<0.0001
 Lobectomy5829 (82.1 %)722 (85.7%)1
 Bilobectomy64 (0.9 %)16 (1.9%)1.88 [1.20–2.94]
 Pneumonectomy21 (0.3 %)16 (1.9%)40.70 [4.75–348.64]
 Segmentectomy1186 (16.7 %)89 (10.5%)0.61 [0.51–0.75]
cT stage0.043
 T14956 (69.8 %)547 (64.8%)
 T1a1
 T1b1.19 [0.99–1.43]
 T1c1.23 [0.94–1.59]
 T21661 (23.4%)215 (25.5%)
 T2a1.22 [0.99–1.49]
 T2b1.38 [0.95–1.99]
 T3391 (5.5 %)67 (8.0%)1.38 [1.02–1.87]
 T492 (1.3%)14 (1.7%)2.06 [1.16–3.65]
 Tis0.67 [0.16–2.84]
cN stage<0.0001
 cN06638 (93.5 %)741 (87.9%)1
 cN1277 (3.9 %)69 (8.2%)2.04 [1.55–2.69]
 cN2178 (2.5 %)31 (3.7%)1.27 [0.84–1.91]
 cN37 (0.1 %)2 (0.2%)4.42 [0.81–24.18]
VariableFull VATS group, n = 7100 Conversion group, n = 843 Odds ratio [95% CI]P-value
Sex<0.0001
 Female3032 (42.6 %)289 (34.2 %)1
 Male4068 (57.3%)554 (65.8 %)1.42 [1.25–1.60]
Age (years)69 ± 11.366.0 ± 9.71.012 [1.006–1.018]0.0002
BMI (kg/m²)25.3 ± 4.626.2 ± 5.01.039 [1.026–1.052]<0.0001
WHO PS0.007
 04366 (61.5%)497 (59.0%)1
 12385 (33.6 %)297 (35.5%)1.19 [1.05–1.35]
 2319 (4.5 %)44 (5.2%)1.14 [0.85–1.52]
 328 (0.4%)4 (0.4%)1.93 [0.85–4.38]
 40 (0%)1 (< 0.1%)
ASA status<0.0001
 ASA 1-24785 (67.4%)520 (61.7%)1
 ASA 3-42315 (32.6%)323 (38.3%)1.32 [1.17–1.50]
History of smoking5495 (77.4%)697 (82.6%)1.22 [1.08–1.37]0.001
Smoking (pack-years)30 ± 14.134.4 ± 25.01.005 [1.003–1.008]<0.0001
Preop. FEV190 ± 19.687.7 ± 19.30.993 [0.990–0.996]<0.0001
Induction CTx134 (1.9 %)19 (2.1%)0.809
Hypertension2201 (31 %)293 (34.8%)1.19 [1.05–1.35]0.007
Pulmonary hypertension7 (< 0.1 %)1 (< 0.1%)0.275
Congestive heart failure28 (0.4 %)6 (0.7%)0.791
Peripheral arterial disease646 (9.1 %)110 (13.1%)1.37 [1.14–1.64]0.001
Valvulopathy78 (1.1 %)14 (1.7%)1.74 [1.04–2.90]0.034
Coronary artery disease646 (9.1 %)107 (12.7%)1.34 [1.11–1.63]0.003
Cardiac arrhythmia475 (6.7 %)76 (9.1%)1.31 [1.04–1.64]0.022
Previous cardiac surgery85 (1.2 %)18 (2.2%)1.75 [1.14–2.70]0.011
Stroke244 (3.3 %)39 (4.6%)1.40 [1.04–1.88]0.025
Antiplatelet therapy320 (4.5 %)53 (6.3%)1.45 [1.12–1.87]0.005
Asthma128 (1.8 %)22 (2.5%)0.220
Sleep apnoea198 (2.8 %)26 (3.1%)0.674
Previous thoracic surgery142 (2.0 %)20 (2.4%)1.12 [0.77–1.63]0.541
Previous thoracic trauma7 (< 0.1 %)6 (0.7%)3.34 [1.39–8]0.007
Alcohol addiction334 (4.7 %)47 (5.6%)0.826
Chronic kidney failure134 (1.9%)33 (3.9%)2.32 [1.70–3.17]<0.0001
Malnutrition45 (0.6%)7 (0.9%)0.597
Thyroid dysfunction270 (3.8 %)34 (4.1%)0.295
Drug addiction45 (0.6 %)12 (1.4%)1.55 [0.81–2.94]0.186
Chronic liver failure41 (0.6 %)7 (0.8%)0.527
Type II diabetes724 (10.2 %)130 (15.4%)1.42 [1.19–1.69]<0.0001
Histological analysis<0.0001
 Primary lung6688 (94.2 %)811 (96.2%)1
 Metastasis292 (4.1 %)24 (2.9%)0.63 [0.48–0.83]
 Benign120 (1.7 %)8 (0.9%)0.40 [0.23–0.69]
Surgery side
 Right3684 (51.9%)423 (50.2%)0.257
 Left3416 (48.1%)420 (49.8%)
Extent of resection<0.0001
 Lobectomy5829 (82.1 %)722 (85.7%)1
 Bilobectomy64 (0.9 %)16 (1.9%)1.88 [1.20–2.94]
 Pneumonectomy21 (0.3 %)16 (1.9%)40.70 [4.75–348.64]
 Segmentectomy1186 (16.7 %)89 (10.5%)0.61 [0.51–0.75]
cT stage0.043
 T14956 (69.8 %)547 (64.8%)
 T1a1
 T1b1.19 [0.99–1.43]
 T1c1.23 [0.94–1.59]
 T21661 (23.4%)215 (25.5%)
 T2a1.22 [0.99–1.49]
 T2b1.38 [0.95–1.99]
 T3391 (5.5 %)67 (8.0%)1.38 [1.02–1.87]
 T492 (1.3%)14 (1.7%)2.06 [1.16–3.65]
 Tis0.67 [0.16–2.84]
cN stage<0.0001
 cN06638 (93.5 %)741 (87.9%)1
 cN1277 (3.9 %)69 (8.2%)2.04 [1.55–2.69]
 cN2178 (2.5 %)31 (3.7%)1.27 [0.84–1.91]
 cN37 (0.1 %)2 (0.2%)4.42 [0.81–24.18]

ASA: American Society of Anesthesiologists; BMI: body mass index; CTx: chemotherapy; preop. FEV1: preoperative forced expiratory volume in 1 s;. WHO PS: World Health Organization performance status.

Table 1:

A univariate analysis of the preoperative characteristics of patients treated with anatomical lung resection with full video-assisted thoracoscopic surgery or intraoperative conversion to thoracotomy

VariableFull VATS group, n = 7100 Conversion group, n = 843 Odds ratio [95% CI]P-value
Sex<0.0001
 Female3032 (42.6 %)289 (34.2 %)1
 Male4068 (57.3%)554 (65.8 %)1.42 [1.25–1.60]
Age (years)69 ± 11.366.0 ± 9.71.012 [1.006–1.018]0.0002
BMI (kg/m²)25.3 ± 4.626.2 ± 5.01.039 [1.026–1.052]<0.0001
WHO PS0.007
 04366 (61.5%)497 (59.0%)1
 12385 (33.6 %)297 (35.5%)1.19 [1.05–1.35]
 2319 (4.5 %)44 (5.2%)1.14 [0.85–1.52]
 328 (0.4%)4 (0.4%)1.93 [0.85–4.38]
 40 (0%)1 (< 0.1%)
ASA status<0.0001
 ASA 1-24785 (67.4%)520 (61.7%)1
 ASA 3-42315 (32.6%)323 (38.3%)1.32 [1.17–1.50]
History of smoking5495 (77.4%)697 (82.6%)1.22 [1.08–1.37]0.001
Smoking (pack-years)30 ± 14.134.4 ± 25.01.005 [1.003–1.008]<0.0001
Preop. FEV190 ± 19.687.7 ± 19.30.993 [0.990–0.996]<0.0001
Induction CTx134 (1.9 %)19 (2.1%)0.809
Hypertension2201 (31 %)293 (34.8%)1.19 [1.05–1.35]0.007
Pulmonary hypertension7 (< 0.1 %)1 (< 0.1%)0.275
Congestive heart failure28 (0.4 %)6 (0.7%)0.791
Peripheral arterial disease646 (9.1 %)110 (13.1%)1.37 [1.14–1.64]0.001
Valvulopathy78 (1.1 %)14 (1.7%)1.74 [1.04–2.90]0.034
Coronary artery disease646 (9.1 %)107 (12.7%)1.34 [1.11–1.63]0.003
Cardiac arrhythmia475 (6.7 %)76 (9.1%)1.31 [1.04–1.64]0.022
Previous cardiac surgery85 (1.2 %)18 (2.2%)1.75 [1.14–2.70]0.011
Stroke244 (3.3 %)39 (4.6%)1.40 [1.04–1.88]0.025
Antiplatelet therapy320 (4.5 %)53 (6.3%)1.45 [1.12–1.87]0.005
Asthma128 (1.8 %)22 (2.5%)0.220
Sleep apnoea198 (2.8 %)26 (3.1%)0.674
Previous thoracic surgery142 (2.0 %)20 (2.4%)1.12 [0.77–1.63]0.541
Previous thoracic trauma7 (< 0.1 %)6 (0.7%)3.34 [1.39–8]0.007
Alcohol addiction334 (4.7 %)47 (5.6%)0.826
Chronic kidney failure134 (1.9%)33 (3.9%)2.32 [1.70–3.17]<0.0001
Malnutrition45 (0.6%)7 (0.9%)0.597
Thyroid dysfunction270 (3.8 %)34 (4.1%)0.295
Drug addiction45 (0.6 %)12 (1.4%)1.55 [0.81–2.94]0.186
Chronic liver failure41 (0.6 %)7 (0.8%)0.527
Type II diabetes724 (10.2 %)130 (15.4%)1.42 [1.19–1.69]<0.0001
Histological analysis<0.0001
 Primary lung6688 (94.2 %)811 (96.2%)1
 Metastasis292 (4.1 %)24 (2.9%)0.63 [0.48–0.83]
 Benign120 (1.7 %)8 (0.9%)0.40 [0.23–0.69]
Surgery side
 Right3684 (51.9%)423 (50.2%)0.257
 Left3416 (48.1%)420 (49.8%)
Extent of resection<0.0001
 Lobectomy5829 (82.1 %)722 (85.7%)1
 Bilobectomy64 (0.9 %)16 (1.9%)1.88 [1.20–2.94]
 Pneumonectomy21 (0.3 %)16 (1.9%)40.70 [4.75–348.64]
 Segmentectomy1186 (16.7 %)89 (10.5%)0.61 [0.51–0.75]
cT stage0.043
 T14956 (69.8 %)547 (64.8%)
 T1a1
 T1b1.19 [0.99–1.43]
 T1c1.23 [0.94–1.59]
 T21661 (23.4%)215 (25.5%)
 T2a1.22 [0.99–1.49]
 T2b1.38 [0.95–1.99]
 T3391 (5.5 %)67 (8.0%)1.38 [1.02–1.87]
 T492 (1.3%)14 (1.7%)2.06 [1.16–3.65]
 Tis0.67 [0.16–2.84]
cN stage<0.0001
 cN06638 (93.5 %)741 (87.9%)1
 cN1277 (3.9 %)69 (8.2%)2.04 [1.55–2.69]
 cN2178 (2.5 %)31 (3.7%)1.27 [0.84–1.91]
 cN37 (0.1 %)2 (0.2%)4.42 [0.81–24.18]
VariableFull VATS group, n = 7100 Conversion group, n = 843 Odds ratio [95% CI]P-value
Sex<0.0001
 Female3032 (42.6 %)289 (34.2 %)1
 Male4068 (57.3%)554 (65.8 %)1.42 [1.25–1.60]
Age (years)69 ± 11.366.0 ± 9.71.012 [1.006–1.018]0.0002
BMI (kg/m²)25.3 ± 4.626.2 ± 5.01.039 [1.026–1.052]<0.0001
WHO PS0.007
 04366 (61.5%)497 (59.0%)1
 12385 (33.6 %)297 (35.5%)1.19 [1.05–1.35]
 2319 (4.5 %)44 (5.2%)1.14 [0.85–1.52]
 328 (0.4%)4 (0.4%)1.93 [0.85–4.38]
 40 (0%)1 (< 0.1%)
ASA status<0.0001
 ASA 1-24785 (67.4%)520 (61.7%)1
 ASA 3-42315 (32.6%)323 (38.3%)1.32 [1.17–1.50]
History of smoking5495 (77.4%)697 (82.6%)1.22 [1.08–1.37]0.001
Smoking (pack-years)30 ± 14.134.4 ± 25.01.005 [1.003–1.008]<0.0001
Preop. FEV190 ± 19.687.7 ± 19.30.993 [0.990–0.996]<0.0001
Induction CTx134 (1.9 %)19 (2.1%)0.809
Hypertension2201 (31 %)293 (34.8%)1.19 [1.05–1.35]0.007
Pulmonary hypertension7 (< 0.1 %)1 (< 0.1%)0.275
Congestive heart failure28 (0.4 %)6 (0.7%)0.791
Peripheral arterial disease646 (9.1 %)110 (13.1%)1.37 [1.14–1.64]0.001
Valvulopathy78 (1.1 %)14 (1.7%)1.74 [1.04–2.90]0.034
Coronary artery disease646 (9.1 %)107 (12.7%)1.34 [1.11–1.63]0.003
Cardiac arrhythmia475 (6.7 %)76 (9.1%)1.31 [1.04–1.64]0.022
Previous cardiac surgery85 (1.2 %)18 (2.2%)1.75 [1.14–2.70]0.011
Stroke244 (3.3 %)39 (4.6%)1.40 [1.04–1.88]0.025
Antiplatelet therapy320 (4.5 %)53 (6.3%)1.45 [1.12–1.87]0.005
Asthma128 (1.8 %)22 (2.5%)0.220
Sleep apnoea198 (2.8 %)26 (3.1%)0.674
Previous thoracic surgery142 (2.0 %)20 (2.4%)1.12 [0.77–1.63]0.541
Previous thoracic trauma7 (< 0.1 %)6 (0.7%)3.34 [1.39–8]0.007
Alcohol addiction334 (4.7 %)47 (5.6%)0.826
Chronic kidney failure134 (1.9%)33 (3.9%)2.32 [1.70–3.17]<0.0001
Malnutrition45 (0.6%)7 (0.9%)0.597
Thyroid dysfunction270 (3.8 %)34 (4.1%)0.295
Drug addiction45 (0.6 %)12 (1.4%)1.55 [0.81–2.94]0.186
Chronic liver failure41 (0.6 %)7 (0.8%)0.527
Type II diabetes724 (10.2 %)130 (15.4%)1.42 [1.19–1.69]<0.0001
Histological analysis<0.0001
 Primary lung6688 (94.2 %)811 (96.2%)1
 Metastasis292 (4.1 %)24 (2.9%)0.63 [0.48–0.83]
 Benign120 (1.7 %)8 (0.9%)0.40 [0.23–0.69]
Surgery side
 Right3684 (51.9%)423 (50.2%)0.257
 Left3416 (48.1%)420 (49.8%)
Extent of resection<0.0001
 Lobectomy5829 (82.1 %)722 (85.7%)1
 Bilobectomy64 (0.9 %)16 (1.9%)1.88 [1.20–2.94]
 Pneumonectomy21 (0.3 %)16 (1.9%)40.70 [4.75–348.64]
 Segmentectomy1186 (16.7 %)89 (10.5%)0.61 [0.51–0.75]
cT stage0.043
 T14956 (69.8 %)547 (64.8%)
 T1a1
 T1b1.19 [0.99–1.43]
 T1c1.23 [0.94–1.59]
 T21661 (23.4%)215 (25.5%)
 T2a1.22 [0.99–1.49]
 T2b1.38 [0.95–1.99]
 T3391 (5.5 %)67 (8.0%)1.38 [1.02–1.87]
 T492 (1.3%)14 (1.7%)2.06 [1.16–3.65]
 Tis0.67 [0.16–2.84]
cN stage<0.0001
 cN06638 (93.5 %)741 (87.9%)1
 cN1277 (3.9 %)69 (8.2%)2.04 [1.55–2.69]
 cN2178 (2.5 %)31 (3.7%)1.27 [0.84–1.91]
 cN37 (0.1 %)2 (0.2%)4.42 [0.81–24.18]

ASA: American Society of Anesthesiologists; BMI: body mass index; CTx: chemotherapy; preop. FEV1: preoperative forced expiratory volume in 1 s;. WHO PS: World Health Organization performance status.

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