Asbjornsson, ViktorJohannsdottir, GydaMyer, DanielRunarsson, Thorri GeirHeitmann, Leon ArnarÓskarsdóttir, Guðrún NínaSilverborn, Per MartinHansen, Henrik JessenGuðbjartsson, Tómas2025-11-202025-11-202024-02-02Asbjornsson, V, Johannsdottir, G, Myer, D, Runarsson, T G, Heitmann, L A, Óskarsdóttir, G N, Silverborn, P M, Hansen, H J & Guðbjartsson, T 2024, 'A successful shift from thoracotomy to video-assisted thoracoscopic lobectomy for non-small cell lung cancer in a low-volume center', Interdisciplinary cardiovascular and thoracic surgery, vol. 38, no. 2, ivae018, pp. ivae018. https://doi.org/10.1093/icvts/ivae0182753-670X21747145068b684e7-3da2-4253-9785-81e5d2b5aa313829079485185902289unpaywall: 10.1093/icvts/ivae018https://hdl.handle.net/20.500.11815/7477Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.OBJECTIVES: Although video-assisted thoracoscopic surgery (VATS) lobectomy has become the gold standard for pulmonary resections of non-small-cell lung cancer (NSCLC), lobectomy is still performed via thoracotomy in many European and North American centres. VATS lobectomy was implemented overnight from thoracotomy in our low-volume centre in early 2019, after 1 senior surgeon undertook observership VATS-training overseas, and immediately became the mainstay of surgical treatment for NSCLC in Iceland. We aimed to investigate our short-term outcomes of VATS lobectomy. METHODS: This was a retrospective study on all pulmonary resections for NSCLC in Iceland 2019-2022, especially focusing on VATS lobectomies, all at cTNM stage I or II. Data were retrieved from hospital charts, including information on perioperative complications, mortality, length of stay and operation time. RESULTS: Out of 204 pulmonary resections, mostly performed by a single senior cardiothoracic surgeon, 169 were lobectomies (82.9%) with 147 out of 169 (87.0%) being VATS lobectomies. Anterolateral thoracotomy was used in 34 cases (16.7%), including 22 lobectomies (64.7%), and 5 (3.4%) conversions from VATS lobectomy. The median postoperative stay for VATS lobectomy was 4 days and the average operating time decreased from 155 to 124 min between the first and last year of the study (P < 0.001). The rate of major and minor complications was 2.7% and 15.6% respectively. One year survival was 95.6% and all patients survived 30 days postoperatively. CONCLUSIONS: The implementation of VATS lobectomy has been successful in our small geographically isolated centre, serving a population of 390 000. Although technically challenging, VATS lobectomy was implemented fast for most NSCLC cases, with short-term outcomes that are comparable to larger high-volume centres.61953762815730ivae018eninfo:eu-repo/semantics/openAccess30-Day mortalityConversionLearning curveLobectomyNon-small-cell lung cancerVideo-assisted thoracoscopic surgeryCardiology and Cardiovascular MedicinePulmonary and Respiratory MedicineSurgerySDG 3 - Good Health and Well-being/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article10.1093/icvts/ivae018