Thoracic Surgery, Glenfield Hospital, Leicester, United Kingdom. Objectives: For many years extrapleural pneumonectomy (EPP) was the oper- ation of choice ...
Interactive CardioVascular and Thoracic Surgery
Abstracts 23rd European Conference on General Thoracic Surgery 31 May–3 June 2015, Lisbon, Portugal B-008 THE EFFECTS OF AN INTENTIONAL TRANSITION FROM EXTRAPLEURAL PNEUMONECTOMY TO EXTENDED PLEURECTOMY-DECORTICATION Annabel Sharkey, S. Tenconi, A. Nakas, D. Waller Thoracic Surgery, Glenfield Hospital, Leicester, United Kingdom Objectives: For many years extrapleural pneumonectomy (EPP) was the operation of choice for the radical management of pleural mesothelioma in the UK. However, doubts surrounding the efficacy of EPP and the change in demographics of the affected population have prompted a transition in our practice towards extended pleurectomy-decortication (EPD). Methods: Data from 362 patients undergoing radical surgery (229 EPD, 133 EPP) were included. Demographics and outcome were compared between the two groups: EPP vs EPD. Results: The mean age of patients undergoing EPD was significantly higher than those undergoing EPP (64.1 years SD ± 7.4 vs 55.8 years SD ± 8.7,
P < 0.001). There was a significantly higher proportion of patients with performance status >0 in the EPD group (46.3% vs 35.4% P = 0.047). Those undergoing EPP had a significantly longer length of in-hospital stay than those undergoing EPD (18 vs 14.5 days P = 0.029). There was a significant difference in re-operation rates between the two groups EPP vs EPD (14.3% vs 7.8% P = 0.027). There was no significant difference in in-hospital, 30-day or 90-day mortality between the 2 groups (P = 0.389, P = 0.464 and P = 0.344 respectively). There was no significant difference in survival or disease-free interval between the two groups (P = 0.899 and P = 0.399 respectively). Survival was significantly longer in patients over the age of 65 undergoing EPD (12.5 vs 4.7 months, P = 0.001). Conclusions: The transition from EPP to EPD in our standard practice has enabled us to operate on more elderly, frail patients with no significant increase in use of hospital resources, and without detriment to overall survival. Disclosure: No significant relationships.
