S88 Poster abstracts of the 17th Annual BTOG / Lung Cancer 127S1 (2019) S1–S102 information to the study server where an algorithm assessed reports and where appropriate triggered alerts to clinicians. Patients also received self-care advice relating to their symptoms. On receipt of an alert, clinicians logged on to a secure web page, viewed the reports and contacted the patient. Alert response data and patient reported outcome measures were analysed. Interviews were conducted with people with MPM, carers and clinicians to determine the feasibility and acceptability of the system in practice. Results: demonstrate that people with MPM, carers and clinicians perceived the remote monitoring of symptoms to be feasible and acceptable. Suggestions were made to enhance future functionality of the system. Conclusion: Findings support conduct of further studies evaluating the effectiveness of remote symptom monitoring in people with MPM and its impact on outcomes including survival. Disclosure: All authors have declared no conflicts of interest. Surgery 211 Video-assisted thoracoscopicsurgical procedures using laryngeal mask (LMA) spontaneous ventilation anaesthesia: an early experience of a novel anaesthetictechnique A. Hussain, M. Ayiomamitis, E. Isaac, V. Tentzeris, M. Chaudhry, M. Loubani, S. Qadri Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, United Kingdom Introduction: Video-assisted thoracic surgery (VATS) under seda- tion with laryngeal mask (LMA) is an emerging novel technique while patient is spontaneous ventilating. Int his technique, patient does not require muscle paralysis, tracheal and double lumen intubation and one lung ventilation. We recently started doing thoracic VATS surgical procedures by this technique such as bullectomyand pleurectomy, plural biopsy, lung biopsy, wedge excisions, decortications. Methods: All patients undergoing VATS thoracic surgery by one of the consultant surgeons were consulted and consented to be involved in our research prior to their operation at the time of their consent for surgery. Patients who were unable to give informed consent were excluded from the study. Inthis technique, surgical pneumothorax is created with the formation of ports which subsequently collapsed the lung with adequate surgical exposure. In our experience, collapsed lung was identical as one lung ventilation. Oxygensaturation was maintained over 95% all the time while end tidal CO2 was very low. Results: At presented we have done 32 patients to report but we are doing these cases regularly. Patients were comfortable during procedures and woke up very quickly after procedures. Standard surgical procedures were performed without any delay or difficulty. There was no complication in peri-operative period and their post op recovery was unremarkable. The overall anaesthetic time and recovery time was significantly reduced as compared to conventional method. Conclusion: Minor VATS procedures can be performed by this technique which is safe and economical, with rapid post op recovery. By reducing the anaesthetic and recovery time we manage to operate more patients. However, it is a new technique which requires further studies. Disclosure: All authors have declared no conflicts of interest. 212 Improving outcomes by reducing AKI in lung cancer surgery: introducing MERITS (Multi-centre Evaluation of Renal Impairment in Thoracic Surgery) V. Naruka 1 , R. Khushiwal 1 , J. Clayton 1 , G. Aresu 2 , A. Peryt 2 , J. Mackay 3 , A. Coonar 4 1 Department of Thoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom, 2 Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom, 3 Department of Anaesthesia & Intensive Care, Royal Papworth Hospital, Cambridge, United Kingdom, 4 Thoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom Introduction: Mortality in thoracic surgery is very low. Risk stratification is difficult with an infrequent outcome measure. We propose acute kidney injury (AKI) as an outcome measure. Incidence of post-operative AKI in thoracic surgery is not well documented. AKI is considered partly preventable. We evaluated unit incidence. Methods: Data on 569 consecutive operations was obtained over 1 year. Renal impairment was classified by KDIGO criteria (Stage 1–3) Results: 261 lung resections were performed of which 183/261 (70%) were VATS. 183 patients (70%) were primary lung cancer of which 113 (62%) were VATS. Of 569 cases, 87(15.3%) developed AKI: stage 1, n=56 (9.8%); stage 2, n=26 (4.6%); and stage 3, n=5 (0.9%). Of 261 lung resections, 52 (19.9%) developed AKI: stage 1, n=31 (11.9%); stage 2, n=17 (6.5%); and stage 3, n=4 (1.53%).VATS vs Open: there was a lower rate of AKI in VATS vs Open procedure for primary lung resections (p=0.0026, 95% CI). Age: in patients >59 years there was a significantly higher rate of AKI (p<0.05) as compared to younger patients. Patients >59 years were significantly more likely to develop AKI after open surgery (p<0.05) than after VATS (p=0.10, 95% CI). This was not the case for younger patients in whom there was no significant increase in rate of AKI. Table 1 (abstract 212) Rates of AKI by procedure Procedure n AKI % All thoracic surgery 569 87 15.3 All lung resections (Open and VATS) 261 52 19.9 Primary lung cancer resection (Open and VATS) 183 39 21.3 Pneumonectomy (all open) 12 4 33 Open lobectomy 58 20 34.5 VATS lobectomy 105 15 14.3 Sublobar resection 56 8 14.3 Conclusion: The incidence of AKI was 15.3% after all thoracic surgery, 19.9% after all lung resections and 21.3% after primary lung cancer resection. In patients undergoing lung cancer resections there was a significant difference for AKI with lower rates in the VATS group. This difference was statistically significant in older patients. To evaluate this further we are undertaking MERITS: Multi-centre Evaluation of Renal Impairment in Thoracic Surgery. This seeks to determine AKI rates in a larger population and is open to thoracic surgery centres in the UK & Ireland (https://royalpapworth.nhs.uk/merits). Disclosure: All authors have declared no conflicts of interest. 213 Is a wedge resection a good surgical alternative to lobectomy? N. Burnside, A. Zuccerelli, D. Spence Thoracic Surgeon, Royal Victoria Hospital, Belfast, United Kingdom Introduction: Anatomical pulmonary lobectomy has long been considered the gold standard for the treatment of early stage, completely resectable, non-small cell lung cancer. The volume of patients undergoing radical treatments for lung cancer has expanded with the use of both stereotactic radiotherapy and radiofrequency