Outcomes
bleeding, heart and kidney failure, vacuum-related, septic shock, periprocedural stroke, multi-organ failure
BLEEDING, SEPTIC SHOCK, EVENT, DIABETES MELLITUS, SECONDARY, LEAKAGE, COMPLICATIONS, MULTI-ORGAN FAILURE
Six of the 17 patients (35%) were postoperatively treated in the ICU, with a median (IQR) ICU stay of 9 (11–303) days. The mean (SD) follow-up time was 76 days (119).Infection resolution without the need for ongoing antibiotic or drainage therapy was achieved in 12 of the 17 (71%) patients. Nine of the 17 patients (53%) were discharged with secondary wound healing of the mini-thoracotomy wound. Three patients required chest tube treatment for a short period following the removal of the vacuum dressing, and all drains were removed before discharge. No vacuum-related complications, such as bleeding or air leakage, were observed. One patient with an otherwise successful course of treatment developed severe periprocedural stroke, which was deemed a non-treatment-related event.Three of the 17 patients (18%) showed multi-organ failure due to septic shock prior to FlexVATS treatment, with all three patients dying during the hospital stay. These patients were all multimorbid and had severe pre-existing conditions (diabetes mellitus, chronic heart and kidney failure, and immunosuppression), making them poor candidates for surgery. Table Patients treated with FlexVATS showed a trend towards reduced 90-day mortality rates compared with VATS or open surgical decortication in the historical cohort (18% versus 41% and 42%, respectively, p = 0.15, Fig. 90-day mortality rates for FlexVATS cohort compared to thoracotomy and VATS. There was a trend in reduction of 90-day mortality rates without reaching statistical significance. Statistical significance was assessed using the Kruskal–Wallis test followed by Dunn’s test for pairwise multiple comparisons of the ranked data. Statistical significance was set at P < 0.05.