Postoperative Pulmonary Complications in Patients Undergoing Elective Thoracotomy Versus Thoracoscopic Surgeries

Iskander S Al-Githmi; Abdulrahman Alotaibi; Alaa Habeebullah; Weam Bajunaid; Sondos Jar; Nadin A Alharbi; Haneen Aziz

doi:10.7759/cureus.45367

Postoperative Pulmonary Complications in Patients Undergoing Elective Thoracotomy Versus Thoracoscopic Surgeries

Cureus. 2023 Sep 16;15(9):e45367. doi: 10.7759/cureus.45367. eCollection 2023 Sep.

Authors

Iskander S Al-Githmi¹, Abdulrahman Alotaibi², Alaa Habeebullah², Weam Bajunaid³, Sondos Jar³, Nadin A Alharbi³, Haneen Aziz³

Affiliations

¹ Cardiothoracic Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
² Thoracic Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
³ Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU.

Abstract

Background Postoperative pulmonary complications correlate highly with thoracic surgery compared to other surgeries. Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical approach that provides considerable advantages over major open thoracotomy. Methodology This is a retrospective cohort study. All patients aged 18 years and above of both genders were included in the study. Cases following up outside King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, were excluded from our study. Complications were measured per the records on follow-up day 1, day 7, and day 30. Mortality was measured within 30 days after the surgery. Results A total of 151 patients were included in the study. Age ranged from 18 to 85 years, with males representing 62.3% of the sample, while Saudis represented 59.6%. VATS was performed in 71.5%, while thoracotomy was performed in 28.5%. Of the total, 19.4% had postoperative complications within 30 days in the VATS group, while 23.3% were in the thoracotomy group. No significant differences were found between the rates of complications between the two groups. Additionally, the admission rate to ICU was significantly twice as common in the thoracotomy group (65.1%) compared to the VATS group (33.3%). Besides, the average duration of the chest tube's stay was three to seven days in both groups (62.1% in the VATS group and 70.7% in the thoracotomy group). Lastly, regarding the requirements of opioids, VATS showed more need for opioids (44.4%) compared to thoracotomy (32.6%). Conclusion The rates of postoperative complications were low in both groups, and no significant differences were found between the two procedures. In addition, the VATS group showed significantly higher use of opioids compared to the thoracotomy group. We recommend conducting further studies with larger sample sizes to increase the statistical power of detection.

Keywords: opioids; postoperative complications; postoperative pulmonary complication; thoracotomy; video-assisted thoracoscopic surgery.