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25Th European Conference on General Thoracic Surgery 25th European Conference on General Thoracic Surgery 28 – 31 May 2017 Congress Innsbruck, Innsbruck, Austria 25th European Conference on General Thoracic Surgery 2 Innsbruck – Austria – 2017 TABLE OF CONTENTS TABLE OF CONTENTS Monday, 29 May 2017 Session I: Brompton 5 ESTS Vogt-Moykopf Lecture 16 Session II: Video I 18 Session III: MITIG VATS Resection 24 Session IV: Young Investigators Award 33 Session V: Mixed Thoracic I 42 Session VI: Innovative/Experimental 51 Tuesday, 30 May 2017 Session VII: Video II 59 Session VIII: Esophagus/Mediastinum 65 Session IX: Interesting Cases 76 Session X: Moderated Posters 85 Session XI: Pulmonary Neoplastic I 103 Session XII: Mixed Thoracic II 115 Session XIII: Pulmonary Neoplastic II 125 Session XIV: Mixed Thoracic III 135 Wednesday, 31 May 2017 Session XV: Video III 145 Posters E-Posters 1 154 E-Posters 2 277 List of Authors 385 3 25th European Conference on General Thoracic Surgery ABSTRACTS 4 Innsbruck – Austria – 2017 ABSTRACTS MONDAY, 29 MAY 2017 08:30 - 10:30 SESSION I: BROMPTON Abstracts 001 - 007 ROOM: TIROL Monday A.M. B-001 PULMONARY HYPERTENSION MAY IMPROVE IN SELECTED PATIENTS AFTER LUNG VOLUME REDUCTION SURGERY Carlson Aruldas, C. Caviezel, D. Schneiter, I. Inci, W. Weder, I. Opitz Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland. Objectives: Pulmonary hypertension (PHT) is considered as contraindication for lung volume reduction surgery (LVRS). Since it has been reported that endobronchial lung volume reduction may have a beneficial effect on PHT in emphysema patients we evaluated the long term effect on pulmonary hypertension in selected patients undergoing thoracoscopic LVRS. Methods: From January 2014 until June 2016 119 LVRS have been performed at our institution. PHT was an absolute contraindication for patients with a homogeneous but tolerated for those with heterogeneous emphysema. Preoperative echocardiography was performed in patients with en- larged pulmonary artery on CT or suspected cardiac disease. Thirty five patients (29.4%) had a transthoracic echocardiography before and after LVRS. Fifteen patients had sPAP pressures > 35mmHg (PHT group) and 20 patients (control group) had normal pulmonary artery (PA) pressures. The effect of LVRS on PA pressures as well as the benefit on lung function were analyzed. Results: Ninety-day mortality of all 35 patients was 0%, ICU and hospitalization time did not differ significantly between the two groups. During a median time of follow-up of 12 months after LVRS, pulmonary hemodynamics improved in 32 out of 35 patients. 3 patients showed no sig- nificance change.For the patients with PHT, PA pressures decreased significantly from median sPAP 40.5mmHg (IQR 39 – 47) to median 36.5mmHg (IQR 36.5 – 39.25, p = 0.04). Further- more, these patients had a significant improvement of FEV1 from 25% (IQR 23 – 34) to 35% (IQR 28 – 41.5, p = 0.01) at 3 months postoperative. All patients including PHT group and control group had an improvement from 25% (IQR 22 – 33.25) to 29% (IQR 25.5 – 37, p < 0.001). All patients are still alive in the PHT group with a median follow up of 18 months. Conclusion: This is the first report which demonstrates that LVRS may improve PHT in patients with het- erogeneous emphysema beside improved lung function and survival. However we consider PHT still an absolute contraindication in patients with homogeneous emphysema. Disclosure: No significant relationships. Keywords: pulmonary hypertension, emphysema, lung volume reduction surgery 5 25th European Conference on General Thoracic Surgery ABSTRACTS B-002 CONVERSION DUE TO VASCULAR INJURY DURING VIDEO ASSISTED THORA- COSCOPIC SURGERY (VATS) LOBECTOMY Fabio Davoli1, L. Bertolaccini1, D. Argnani2, J. Brandolini2, A. Pardolesi2, D. Divisi3, R. Crisci3, P. Solli1, on behalf of the Italian VATS Group4 1Thoracic Surgery, AUSL Romagna - Ravenna Teaching Hospital, Ravenna, Italy 2Thoracic Surgery, AUSL Romagna - Forlì Teaching Hospital, Forlì, Italy 3Thoracic Surgery, University of L’Aquila - “Mazzini” Teaching Hospital Teramo, Teramo, Italy 4Thoracic Surgery, National Registry, National Registry, Italy Objectives: VATS lobectomy experienced a dramatic growth worldwide in the last 25 years. Vascular in- juries are acknowledged among the most serious causes of unplanned emergency conversion. We assessed the incidence of vascular injuries and analysed the related risk factors using our prospective National VATS lobectomy registry. Methods: A National Registry for VATS lobectomy established in 2013 was used to collect data from 65 Thoracic Surgery Units. Out of more than 3,700 patients enrolled, only information from Units with >100 VATS lobectomies were retrospectively analysed. Unpaired Student’s t–tests, Fisher’s exact-tests, Pearson’s χ2, Spearman’s-rho were applied as needed. Univariate analysis was performed on selected variables; significant variables (p <0.30) were entered into a Cox multivariable logistic regression model. Results: Ten institutions contributed a total of 1,679 patients (Table 1a). Vascular injuries leading to conversion occurred in 44 (2.6%) patients; surgical details were summarized in Table 1b. Se- niority was inversely related to the risk of vascular injuries (rho=–0.54). Univariate analysis (Table 1c) showed that age, gender, surgical volume activity, Charlson Index Score and number of resected lymph-nodes were crucial variables (p<0.30). Unexpectedly, triportal vs. biportal vs. uniportal approaches were not significantly associated with injuries leading to conversion. Multivariate analysis (Table 1d) showed that only number of resected lymph-nodes, VATS ex- perience ratio (i.e., number of VATS lobectomies/total lobectomies performed in same year at same centre), and surgical volume of centre were variables significantly associated with the risk of conversion. Emergency thoracotomy was strongly correlated with postoperative morbidity (rho=0.68). 6 Innsbruck – Austria – 2017 ABSTRACTS Table 1. Demographics, surgical details, univariate and multivariate analysis. CI = Confidence Inter- val, ECOG = Eastern Cooperative Oncology Group, NA = Not Applicable, OR = Odds Ratio, SD = Standard Deviation Abstracts 001 - 007 Table 1a. Demographics Monday A.M. No. % Male 1003 59.74 Gender Female 676 40.26 Age (mean ± SD) 67.27 ± 10.37 Malignant 1560 92.91 Histology Metastasis 68 5.98 Benign 51 3.04 Left upper lobectomy 367 21.86 Left lower lobectomy 277 16.50 Right upper lobectomy 607 36.15 Stratified Procedure Right lower lobectomy 290 17.27 Right middle lobectomy 120 7.15 Upper bilobectomy 6 0.36 Lower bilobectomy 12 0.71 Left 644 38.36 Side Right 1035 61.44 Chemotherapy 57 3.39 Neoadjuvant Therapy Radiotherapy 8 0.47 None 1614 96.12 VATS Experience Ratio (mean ± SD) 44.24 ± 19.98 Adenocarcinoma 1084 68.56 Squamous cell carcinoma 265 16.76 Definitive Histology (Avail- Typical carcinoid 83 5.24 able data on 1581 patients) Atypical carcinoid 30 1.89 Metastasis 68 4.30 Benign 51 3.03 IA 949 58.29 IB 338 20.76 p Stage (TNM VII Edition, IIA 150 9.22 2009) [Available data on 1628 IIB 51 3.14 patients] IIIA 128 7.86 IIIB 3 0.19 IV 9 0.56 7 25th European Conference on General Thoracic Surgery ABSTRACTS Table 1b. Surgical details of the 44 converted patients No. % p-value Left 19 43.18 Side 0.501 Right 25 56.82 Left upper lobectomy 14 31.81 Left lower lobectomy 5 11.36 Right upper lobectomy 13 29.55 Stratified Procedure 0.731 Right lower lobectomy 8 18.18 Right middle lobectomy 3 6.82 Lower bilobectomy 1 2.28 <2 19 43.18 2 — 3 11 25.00 Tumour size (cm) 0.167 3 — 5 9 20.46 5 — 7 5 11.36 1 4 9.09 2 7 15.91 Number of Incisions 0.853 3 27 61.36 >3 6 13.64 Neoadjuvant Therapy Chemotherapy 1 2.27 NA Table 1c. Univariate Analysis Variable p-value Age 0.0042 Surgical Volume 0.102 VATS Experience Ratio 0.126 Gender 0.247 Previous Surgery 0.810 Neoadjuvant Chemotherapy 0,319 Neoadjuvant Radiotherapy 0,783 Side 0.505 Charlson Index 0.009 ECOG Score 0.884 Number of Incisions 0.492 Number of Resected Lymph Nodes 0.150 Overall Postoperative Complications 0.106 Hospital Length of Stay 0.757 8 Innsbruck – Austria – 2017 ABSTRACTS Table 1d. Multivariate Analysis Variable OR 95% CI p-value Age 1.01 0.98 - 1.06 0.18 Abstracts 001 - 007 Gender 0.94 0.86 - 1.80 0.16 Monday A.M. Surgical Volume 0.97 0.94 - 0.99 0.0021 VATS Experience Score 1.56 1.21 - 2.34 0.043 Charlson Index 1.48 0.71 - 3.11 0.34 Number of Resected Lymph Nodes 2.64 1.11 - 3.28 0.041 Overall Postoperative Complications 1.07 0.91 - 1.36 0.054 Conclusion: Vascular injuries during VATS lobectomies represent infrequent complications, but directly affect postoperative outcome. Not surprisingly, the surgical volume and the patient comorbidi- ties are among the strongest predictive factors for conversion. Number of ports used for VATS lobectomy did not influence the risk of vascular damages while the number of resected lymph- nodes strongly increased the risk of injuries and conversion. Disclosure: No significant relationships. Keywords: vascular injury, complications, lymphadenectomy, National Registry, VATS lobec- tomy, conversion 9 25th European Conference on General Thoracic Surgery ABSTRACTS B-003 VIDEO-ASSISTED THORACOSCOPIC SURGERY VERSUS OPEN SURGERY FOR STAGE I THYMIC EPITHELIAL TUMORS: A PROPENSITY-SCORE MATCHED ANALYSIS OF THE CHINESE ALLIANCE FOR RESEARCH IN THYMOMAS RET- ROSPECTIVE DATABASE Zhitao Gu1, W. Fang1, C. Chen2, P. Zhang3, Y. Wei4, J. Fu5, Y. Liu6, R. Zhang7, K. Chen8, Z. Yu9 1Thoracic Surgery, Shanghai Chest Hospital, Shanghai, China 2Thoracic Surgery, Fujian Medical
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