Results of a retrospective analysis before and after matching analysi s

Thoracic Cancer (2021) 1279 1290 12 – Abstract Background: Here, we report our initial experience with subxifoid video-assisted thoracoscopic surgery (SVATS) lobectomy for the management of primary lung cancer, and compared the outcomes of SVATS with those of conventional transthoracic VATS (CVATS) lobectom ies to validate its feasibility and usefulness. Methods: The clini cal data of consecutive patients undergoing VATS lobectomy via SVATS or CVATS for lung can cer were retrospecti vely compared. The endpoints were to evaluate the statistical differences in surgical results, postoperative pain (measured with visual analog scale [VAS] scores at 8 hours, Day 1, Day 2, Day 3, at discharge, one mo nth and three months after surgery) and paresthesia (measured at onemonth, and three months after surgery). The two groups were compared before and after matching analysis. Results: Our study population included 223 patients: 84 in the SVATS and 139 in the CVATS group. The two groups were not comparable for sex (P = 0.001), preoperative comorbidity as cardiopathy (P = 0.007), BMI value (P = 0.003), left-sided procedure (P P P = 0.04), tumor stage ( = 0.04), and tumor size ( = 0.002). These differences were overcome by propensity score matching (PSM) analysis that yielded two well-matched groups which included 61 patients in each group. Surgical outcomes including blood loss, hospital stay and complications were similar before and after matching analysis, but SVATS compared to CVATS was associated with longer operative time before (159  13 vs. 126  6.3, P < 0.0001), and after matching analysis (161  23 vs. 119  8.3; P < 0.0001) and signicant reduction of postoperative pain during the different time-points (P P P < 0.001), and paresthesia at one ( = 0.001), and three months ( < 0.0001). Conclusions: SVATS lobectomy is a feasible and safe strategy with surgical outcomes similar to CVATS lobectomy but with less postoperative pain and paresthesia.