Cross-sectional survey on Chinese surgeons’ practice patterns and views on video-assisted thoracoscopic surgery

Gui Su, Lingling Cai


Background: Surgeons’ opinions on video-assisted thoracoscopic surgery (VATS) may influence VATS adoption. This study aims to understand Chinese surgeons’ view on VATS.
Methods: A questionnaire was developed to collect surgeons’ opinions on the benefits of VATS over open procedures, potential obstacles to adopt VATS, and possible indications and contraindications of VATS to treat lung cancer.
Results: Ninety-six surgeons from ≥75 hospitals in ≥23 provinces completed the questionnaire. Of them, 95.8% were thoracic surgeons; 38.5%, 30.2%, and 28.1% were chief, associate chief, and attending surgeons, respectively. The chief and associate chief surgeons had significantly more years of experiences in VATS and higher monthly VATS volume than the attending surgeons (All P<0.05). Notably, compared with only 32.4% of the chief surgeons, 55.6% of the attending and 55.2% of the associate chief surgeons answered a proportion of VATS >75% in their practice. The top three mostly agreed (96.9–92.7%) benefits of VATS were shortening hospital stay, reducing postoperative pain, and decreasing the incidence of postoperative complications. In addition, 81% of the 96 surgeons agreed that VATS could reduce drug fee. The mostly agreed (70.8%) potential obstacle for VATS adoption was insufficient training for surgeons. The opinions on the benefit of VATS and hurdles to adopt VATS were consistent across the three professional titles. The mostly agreed indication (91.7%) and contraindication (80.2%) were stage I and II non-small cell lung cancer and inability to tolerate single lung ventilation, respectively.
Conclusions: Chinese thoracic surgeons consistently agreed on clinical benefits and indications of VATS and believed insufficient training as a key obstacle to adopt VATS.