BACKGROUND: Since 2001 we have utilized a novel surgical approach for @entity20330 in which lobectomy and mediastinal lymph node dissection are performed directly though the chest wall defect. The defect is then patched at the completion of the procedure ("cut-in patch-out") thereby avoiding a separate thoracotomy with rib spreading. We undertook a study to compare outcomes of this novel "cut-in patch-out" technique with traditional thoracotomy for @entity1 with @entity20330 . METHODS: We retrospectively identified 41 @entity1 undergoing surgical resection of @entity20330 requiring en-bloc removal of at least 3 ribs at our institution from 1999 to 2012. Surgery was accomplished by either a "cut-in patch-out" technique (n   =   25) or traditional posterolateral thoracotomy and separate chest wall resection (n   =   16). Multiple variables including @entity1 demographics, neoadjuvant therapy, extent of resection, and pathology were analyzed with respect to outcomes from morbidity, narcotic use, and oncologic perspectives. RESULTS: Baseline demographics, neoadjuvant therapy, and perioperative factors including extent of surgery, complete resections (R0), nodal status and lymph node number, morbidity, and mortality were similar between the two groups. The mean duration of out- @entity1 narcotic use was significantly lower in the "cut-in patch-out" group compared to the thoracotomy group (80.6 days        62.4 vs. 158.2 days        119.2, p   <   0.01). Using multivariate regression analysis, the traditional thoracotomy technique (OR 7.72; p   =   0.01) was independently associated with prolonged oral narcotic requirements (>100 days). Additionally, five year survival for the "cut-in patch-out" group was 48% versus the traditional group at 12.5% (p   =   0.04). CONCLUSIONS: Compared with a traditional thoracotomy and separate chest wall resection approach for P-NSCLC, a "cut-in patch-out" technique offers an alternative approach that appears to have at least oncologic equivalence while decreasing @entity158 . We have more recently adapted this technique to select @entity1 with @entity2 involving chest wall invasion and believe further investigation is warranted.

The "cut-in patch-out" technique for XXXX resections results in postoperative pain reduction: a case control study.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity2 :: ('MESH:D008175', 'Disease') :: ['pulmonary neoplasms'] @entity20330 :: ('MESH:D010178', 'Disease') :: ['Pancoast tumors'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity20330 :: (MESH:D010178,Disease) :: ['Pancoast tumor']
