DOI: 10.36347/sjams.2020.v08i05.037

Pages: 1361-1364

Introduction: Video assisted thoracoscopy (VATS) lobectomy has become a standard approach in the management of patients with lung cancer, more so in the recent years. As many literatures has claimed benefits of VATS over thoracotomy in terms of clinical settings, it is also equally important to evaluate whether these benefits translate into cost implications. Objectives: The aim of this study is to investigate the postoperative complications and mortality following VATS lobectomy compared to Open lobectomy and to evaluate whether these clinical implications could translate into cost effectiveness. Materials and methods: A retrospective study of all patients who underwent lobectomy performed by a single surgeon between the year 2014 to 2019 was conducted. Data was obtained through patient’s medical notes. Results: A total of 81 patients underwent lobectomy under a single surgeon (VATS n= 39, Thoracotomy n=42). Patients demographics were similar in both groups. Operating time were also similar in both groups. Epidural requirement (hours) were significantly shorter in VATS group (34.8 ± 19.8 vs 55.6 ± 17.9, p<0.001) There were more blood loss in Thoracotomy group (1.4 ± 0.8g/dl vs 1.0 ± 0.5g/dl, p= 0.044). Chest tube days were significantly shorter in the VATS group (4.8 ± 3.8days vs. 7.6 ± 9.2days, p=0.01) and so was length of stay (6.8 ± 4.0 days vs. 8.9 ± 5.9days p=0.026). There were no <30days mortality in both groups. >90days mortality were similar in both groups (21.4% vs 15.4%, p=0.484). Total cost of stay was higher in the Thoracotomy group (RM10,488± 4,436 vs. RM9205 ± 4420, p=0.196). Conclusions: Lobectomy performed via VATS approach results in less epidural requirement, shorter chest tube duration, less blood loss, shorter hospital stay. Shorter duration of hospital stay translates into less cost for the patient and hospital.