Saving the split

The benefits of VATS thymectomy

Daniel J. Gross, Bardiya Zangbar, Nagarajan Muthu, Erin H. Chang, Abbasali Badami, Louis Stein, Rainer W G Gruessner, Robert Poston

Research output: Contribution to journalArticle

Abstract

Background: With the advent of minimally invasive techniques, the standard approaches to many surgeries have changed. We compared the financial costs and health care outcomes between standard thymectomy via sternotomy and video assisted thoracoscopic surgery (VATS). Methods: A 3-year review [2010–2012] of the National Inpatient Sample (NIS) was performed. All patients undergoing thymectomy were included. Patients undergoing VATS thymectomy were identified. Outcomes measured were hospital length of stay (LOS), hospital charges, and mortality. Univariate and multivariate analyses were performed to control for demographics and comorbidities. Results: The results of 2,065 patients who underwent thymectomy were analyzed, of which 373 (18.1%) had VATS thymectomy and 1,692 (81.9%) had standard thymectomy. Mean age was 52.8±16, 42.5% were male, and 65.5% were Caucasian. There was a significant interval increase in number of patients undergoing VATS thymectomy (10% in 2010 vs. 19.2% in 2012, P<0.001). Patients undergoing standard thymectomy had longer hospital LOS (6.8±6.6 vs. 3.3d±3.4 d, P<0.001), hospital charges $88,838±$120,892 vs. $57,251±$54,929) and hospital mortality (0.9% vs. 0%, P=0.01). In multivariate analysis, thymectomy via sternotomy was independently associated with increased hospital LOS B =1.6 d, P<0.001) and charges (B = $13,041, P=0.041). Conclusions: Our study demonstrates decreased hospital length of stay and reduced hospital charges in patients undergoing VATS thymectomy compared to standard thymectomy. Our data demonstrates that the prevalence of VATS thymectomies is increasing, likely related to improved healthcare and financial outcomes.

Original languageEnglish (US)
Pages (from-to)1428-1432
Number of pages5
JournalJournal of Thoracic Disease
Volume11
Issue number4
DOIs
StatePublished - Apr 1 2019
Externally publishedYes

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Video-Assisted Thoracic Surgery
Thymectomy
Length of Stay
Hospital Charges
Sternotomy
Hospital Mortality
Multivariate Analysis
Health Care Costs
Comorbidity
Inpatients

Keywords

  • Mediastinum
  • Minimally invasive
  • Thymectomy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Gross, D. J., Zangbar, B., Muthu, N., Chang, E. H., Badami, A., Stein, L., ... Poston, R. (2019). Saving the split: The benefits of VATS thymectomy. Journal of Thoracic Disease, 11(4), 1428-1432. https://doi.org/10.21037/jtd.2019.03.51

Saving the split : The benefits of VATS thymectomy. / Gross, Daniel J.; Zangbar, Bardiya; Muthu, Nagarajan; Chang, Erin H.; Badami, Abbasali; Stein, Louis; Gruessner, Rainer W G; Poston, Robert.

In: Journal of Thoracic Disease, Vol. 11, No. 4, 01.04.2019, p. 1428-1432.

Research output: Contribution to journalArticle

Gross, DJ, Zangbar, B, Muthu, N, Chang, EH, Badami, A, Stein, L, Gruessner, RWG & Poston, R 2019, 'Saving the split: The benefits of VATS thymectomy', Journal of Thoracic Disease, vol. 11, no. 4, pp. 1428-1432. https://doi.org/10.21037/jtd.2019.03.51
Gross DJ, Zangbar B, Muthu N, Chang EH, Badami A, Stein L et al. Saving the split: The benefits of VATS thymectomy. Journal of Thoracic Disease. 2019 Apr 1;11(4):1428-1432. https://doi.org/10.21037/jtd.2019.03.51
Gross, Daniel J. ; Zangbar, Bardiya ; Muthu, Nagarajan ; Chang, Erin H. ; Badami, Abbasali ; Stein, Louis ; Gruessner, Rainer W G ; Poston, Robert. / Saving the split : The benefits of VATS thymectomy. In: Journal of Thoracic Disease. 2019 ; Vol. 11, No. 4. pp. 1428-1432.
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abstract = "Background: With the advent of minimally invasive techniques, the standard approaches to many surgeries have changed. We compared the financial costs and health care outcomes between standard thymectomy via sternotomy and video assisted thoracoscopic surgery (VATS). Methods: A 3-year review [2010–2012] of the National Inpatient Sample (NIS) was performed. All patients undergoing thymectomy were included. Patients undergoing VATS thymectomy were identified. Outcomes measured were hospital length of stay (LOS), hospital charges, and mortality. Univariate and multivariate analyses were performed to control for demographics and comorbidities. Results: The results of 2,065 patients who underwent thymectomy were analyzed, of which 373 (18.1{\%}) had VATS thymectomy and 1,692 (81.9{\%}) had standard thymectomy. Mean age was 52.8±16, 42.5{\%} were male, and 65.5{\%} were Caucasian. There was a significant interval increase in number of patients undergoing VATS thymectomy (10{\%} in 2010 vs. 19.2{\%} in 2012, P<0.001). Patients undergoing standard thymectomy had longer hospital LOS (6.8±6.6 vs. 3.3d±3.4 d, P<0.001), hospital charges $88,838±$120,892 vs. $57,251±$54,929) and hospital mortality (0.9{\%} vs. 0{\%}, P=0.01). In multivariate analysis, thymectomy via sternotomy was independently associated with increased hospital LOS B =1.6 d, P<0.001) and charges (B = $13,041, P=0.041). Conclusions: Our study demonstrates decreased hospital length of stay and reduced hospital charges in patients undergoing VATS thymectomy compared to standard thymectomy. Our data demonstrates that the prevalence of VATS thymectomies is increasing, likely related to improved healthcare and financial outcomes.",
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