Summary of responses regarding perioperative management of VATS lobectomy procedures from the panel of international VATS experts
| Perioperative management of VATS lobectomy . | Number of respondents (%) . |
|---|---|
| Preoperative investigation for N-status should include | |
| PET/CT and sampling of positive mediastinal lymph nodes | 40 (80) |
| PET/CT and routine sampling of mediastinal lymph nodes | 9 (18) |
| PET/CT only | 1 (2) |
| Your preferred approach to sample mediastinal lymph nodes | |
| EBUS/EUS | 30 (60) |
| Mediastinoscopy | 18 (36) |
| VAMLA | 1 (2) |
| I do not sample lymph nodes preoperatively | 1 (2) |
| Would you undertake VATS assessment routinely at the time of surgical resection? | |
| Yes | 38 (76) |
| No | 12 (24) |
| The most appropriate management of mediastinal lymph nodes is: | |
| Total ipsilateral lymph node dissection | 33 (66) |
| Lobe specific lymph node dissection | 6 (12) |
| Systematic lymph node sampling | 11 (22) |
| Lobe specific sampling | 0 |
| Random/no sampling | 0 |
| Which group(s) would you recommend to have total ipsilateral lymph node dissection?a | |
| All patients | 33 (66) |
| Central tumour | 13 (26) |
| Patients unfit for adjuvant chemotherapy or radiotherapy | 5 (10) |
| N1-positive disease | 15 (30) |
| N2-positive disease | 14 (28) |
| None of above | 1 (2) |
| Under which of the following clinical situation(s), would you recommend conversion to open thoracotomy?a | |
| Pneumonectomy | 17 (34) |
| Bronchial sleeve | 27 (54) |
| Vascular sleeve | 48 (96) |
| Broncho-vascular sleeve | 48 (96) |
| Pleural adhesions | 2 (4) |
| Absence of fissure | 1 (2) |
| Poor lung deflation | 12 (24) |
| Major bleeding | 46 (92) |
| Broncho-pleural fistula | 18 (36) |
| Chest wall involvement | 30 (60) |
| Operating theatre time pressure | 2 (4) |
| None of above | 0 |
| Your preferred loco-regional postoperative pain management is | |
| PCA only | 6 (12) |
| Epidural | 17 (34) |
| Paravertebral | 10 (20) |
| Intercostal nerve block | 17 (34) |
| Others | 0 |
| Perioperative management of VATS lobectomy . | Number of respondents (%) . |
|---|---|
| Preoperative investigation for N-status should include | |
| PET/CT and sampling of positive mediastinal lymph nodes | 40 (80) |
| PET/CT and routine sampling of mediastinal lymph nodes | 9 (18) |
| PET/CT only | 1 (2) |
| Your preferred approach to sample mediastinal lymph nodes | |
| EBUS/EUS | 30 (60) |
| Mediastinoscopy | 18 (36) |
| VAMLA | 1 (2) |
| I do not sample lymph nodes preoperatively | 1 (2) |
| Would you undertake VATS assessment routinely at the time of surgical resection? | |
| Yes | 38 (76) |
| No | 12 (24) |
| The most appropriate management of mediastinal lymph nodes is: | |
| Total ipsilateral lymph node dissection | 33 (66) |
| Lobe specific lymph node dissection | 6 (12) |
| Systematic lymph node sampling | 11 (22) |
| Lobe specific sampling | 0 |
| Random/no sampling | 0 |
| Which group(s) would you recommend to have total ipsilateral lymph node dissection?a | |
| All patients | 33 (66) |
| Central tumour | 13 (26) |
| Patients unfit for adjuvant chemotherapy or radiotherapy | 5 (10) |
| N1-positive disease | 15 (30) |
| N2-positive disease | 14 (28) |
| None of above | 1 (2) |
| Under which of the following clinical situation(s), would you recommend conversion to open thoracotomy?a | |
| Pneumonectomy | 17 (34) |
| Bronchial sleeve | 27 (54) |
| Vascular sleeve | 48 (96) |
| Broncho-vascular sleeve | 48 (96) |
| Pleural adhesions | 2 (4) |
| Absence of fissure | 1 (2) |
| Poor lung deflation | 12 (24) |
| Major bleeding | 46 (92) |
| Broncho-pleural fistula | 18 (36) |
| Chest wall involvement | 30 (60) |
| Operating theatre time pressure | 2 (4) |
| None of above | 0 |
| Your preferred loco-regional postoperative pain management is | |
| PCA only | 6 (12) |
| Epidural | 17 (34) |
| Paravertebral | 10 (20) |
| Intercostal nerve block | 17 (34) |
| Others | 0 |
aMore than one answer option allowed.
Summary of responses regarding perioperative management of VATS lobectomy procedures from the panel of international VATS experts
| Perioperative management of VATS lobectomy . | Number of respondents (%) . |
|---|---|
| Preoperative investigation for N-status should include | |
| PET/CT and sampling of positive mediastinal lymph nodes | 40 (80) |
| PET/CT and routine sampling of mediastinal lymph nodes | 9 (18) |
| PET/CT only | 1 (2) |
| Your preferred approach to sample mediastinal lymph nodes | |
| EBUS/EUS | 30 (60) |
| Mediastinoscopy | 18 (36) |
| VAMLA | 1 (2) |
| I do not sample lymph nodes preoperatively | 1 (2) |
| Would you undertake VATS assessment routinely at the time of surgical resection? | |
| Yes | 38 (76) |
| No | 12 (24) |
| The most appropriate management of mediastinal lymph nodes is: | |
| Total ipsilateral lymph node dissection | 33 (66) |
| Lobe specific lymph node dissection | 6 (12) |
| Systematic lymph node sampling | 11 (22) |
| Lobe specific sampling | 0 |
| Random/no sampling | 0 |
| Which group(s) would you recommend to have total ipsilateral lymph node dissection?a | |
| All patients | 33 (66) |
| Central tumour | 13 (26) |
| Patients unfit for adjuvant chemotherapy or radiotherapy | 5 (10) |
| N1-positive disease | 15 (30) |
| N2-positive disease | 14 (28) |
| None of above | 1 (2) |
| Under which of the following clinical situation(s), would you recommend conversion to open thoracotomy?a | |
| Pneumonectomy | 17 (34) |
| Bronchial sleeve | 27 (54) |
| Vascular sleeve | 48 (96) |
| Broncho-vascular sleeve | 48 (96) |
| Pleural adhesions | 2 (4) |
| Absence of fissure | 1 (2) |
| Poor lung deflation | 12 (24) |
| Major bleeding | 46 (92) |
| Broncho-pleural fistula | 18 (36) |
| Chest wall involvement | 30 (60) |
| Operating theatre time pressure | 2 (4) |
| None of above | 0 |
| Your preferred loco-regional postoperative pain management is | |
| PCA only | 6 (12) |
| Epidural | 17 (34) |
| Paravertebral | 10 (20) |
| Intercostal nerve block | 17 (34) |
| Others | 0 |
| Perioperative management of VATS lobectomy . | Number of respondents (%) . |
|---|---|
| Preoperative investigation for N-status should include | |
| PET/CT and sampling of positive mediastinal lymph nodes | 40 (80) |
| PET/CT and routine sampling of mediastinal lymph nodes | 9 (18) |
| PET/CT only | 1 (2) |
| Your preferred approach to sample mediastinal lymph nodes | |
| EBUS/EUS | 30 (60) |
| Mediastinoscopy | 18 (36) |
| VAMLA | 1 (2) |
| I do not sample lymph nodes preoperatively | 1 (2) |
| Would you undertake VATS assessment routinely at the time of surgical resection? | |
| Yes | 38 (76) |
| No | 12 (24) |
| The most appropriate management of mediastinal lymph nodes is: | |
| Total ipsilateral lymph node dissection | 33 (66) |
| Lobe specific lymph node dissection | 6 (12) |
| Systematic lymph node sampling | 11 (22) |
| Lobe specific sampling | 0 |
| Random/no sampling | 0 |
| Which group(s) would you recommend to have total ipsilateral lymph node dissection?a | |
| All patients | 33 (66) |
| Central tumour | 13 (26) |
| Patients unfit for adjuvant chemotherapy or radiotherapy | 5 (10) |
| N1-positive disease | 15 (30) |
| N2-positive disease | 14 (28) |
| None of above | 1 (2) |
| Under which of the following clinical situation(s), would you recommend conversion to open thoracotomy?a | |
| Pneumonectomy | 17 (34) |
| Bronchial sleeve | 27 (54) |
| Vascular sleeve | 48 (96) |
| Broncho-vascular sleeve | 48 (96) |
| Pleural adhesions | 2 (4) |
| Absence of fissure | 1 (2) |
| Poor lung deflation | 12 (24) |
| Major bleeding | 46 (92) |
| Broncho-pleural fistula | 18 (36) |
| Chest wall involvement | 30 (60) |
| Operating theatre time pressure | 2 (4) |
| None of above | 0 |
| Your preferred loco-regional postoperative pain management is | |
| PCA only | 6 (12) |
| Epidural | 17 (34) |
| Paravertebral | 10 (20) |
| Intercostal nerve block | 17 (34) |
| Others | 0 |
aMore than one answer option allowed.
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