What is difficult about doing video-assisted thoracic surgery (VATS)? A retrospective study comparing VATS anatomical resection and conversion to thoracotomy for lung cancer in a university-based hospital

To analyze causes and clinical outcomes of conversion to thoracotomy during video-assisted thoracic surgery (VATS) anatomical resection for patients with non-small cell lung cancer. A total of 245 consecutive pulmonary resections were performed from January 2013 to July 2016 at Chungbuk National University Hospital. Patients who underwent curative, anatomical resection for lung cancer were included in the study. Preoperative basal characteristics, functional factors, radiologic findings and clinical outcomes were compared between converted and non-converted patients. Of the 245 patients, 91 (benign disease) and 17 (non-anatomical resection) were excluded from the study. Of the 137 remaining patients, 51 (37%) who received anatomical resection via VATS and 38 (28%) via conversion to thoracotomy were included in the study, but 48 (35%) with planned thoracotomy were excluded. Gender, previous medical history, American Society of Anesthesiologists (ASA) score, body mass index (BMI) and forced expiratory volume for 1 second (FEV ) were not different between the two groups. However, age (P