Yan Tristan D, Cao Christopher, D'Amico Thomas A, Demmy Todd L, He Jianxing, Hansen Henrik, Swanson Scott J, Walker William S
The Collaborative Research (CORE) group, Sydney, Australia.
Eur J Cardiothorac Surg. 2014 Apr;45(4):633-9. doi: 10.1093/ejcts/ezt463. Epub 2013 Oct 14.
Video-assisted thoracoscopic surgery (VATS) lobectomy has been gradually accepted as an alternative surgical approach to open thoracotomy for selected patients with non-small-cell lung cancer (NSCLC) over the past 20 years. The aim of this project was to standardize the perioperative management of VATS lobectomy patients through expert consensus and to provide insightful guidance to clinical practice.
A panel of 55 experts on VATS lobectomy was identified by the Scientific Secretariat and the International Scientific Committee of the '20th Anniversary of VATS Lobectomy Conference-The Consensus Meeting'. The Delphi methodology consisting of two rounds of voting was implemented to facilitate the development of consensus. Results from the second-round voting formed the basis of the current Consensus Statement. Consensus was defined a priori as more than 50% agreement among the panel of experts. Clinical practice was deemed 'recommended' if 50-74% of the experts reached agreement and 'highly recommended' if 75% or more of the experts reached agreement.
Fifty VATS lobectomy experts (91%) from 16 countries completed both rounds of standardized questionnaires. No statistically significant differences in the responses between the two rounds of questioning were identified. Consensus was reached on 21 controversial points, outlining the current accepted definition of VATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions.
The present Consensus Statement represents a collective agreement among 50 international experts to establish a standardized practice of VATS lobectomy for the thoracic surgical community after 20 years of clinical experience.
在过去20年里，电视辅助胸腔镜手术（VATS）肺叶切除术已逐渐被选定的非小细胞肺癌（NSCLC）患者接受，作为开胸手术的替代手术方法。本项目的目的是通过专家共识规范VATS肺叶切除术患者的围手术期管理，并为临床实践提供有见地的指导。
“VATS肺叶切除术20周年会议——共识会议”的科学秘书处和国际科学委员会确定了55名VATS肺叶切除术专家组成的小组。采用两轮投票的德尔菲方法以促进达成共识。第二轮投票的结果构成了当前共识声明的基础。事先将共识定义为专家小组中超过50%的人达成一致。如果50%-74%的专家达成一致，临床实践被视为“推荐”；如果75%或更多的专家达成一致，则被视为“高度推荐”。
来自16个国家的50名VATS肺叶切除术专家（91%）完成了两轮标准化问卷。两轮提问的回答之间未发现统计学上的显著差异。就21个有争议的问题达成了共识，概述了VATS肺叶切除术目前公认的定义、其适应证和禁忌证、围手术期临床管理以及培训和未来研究方向的建议。
本共识声明代表了50位国际专家的集体共识，在20年临床经验后为胸外科界建立了标准化的VATS肺叶切除术实践。
