A Comparative Study of Video‐Assisted Thoracic Surgery with Thoracotomy for Middle Lobe Syndrome

Abstract

ObjectivesThe aim of this study is to evaluate the feasibility and safety of video-assisted thoracic surgery (VATS) for the treatment of middle lobe syndrome (MLS) through comparison with thoracotomy during the same period.MethodsWe retrospectively reviewed all consecutive patients with MLS who underwent lobectomy or lingular segmentectomy between December 2005 and November 2015 in a single institute. Thirty patients were enrolled and divided into two groups: VATS group (n = 19) and thoracotomy group (n = 11). Data regarding the patients’ demographics, medical history were collected and statistically compared.ResultsAll patients received successful middle lobe resection or lingular segmentectomy. In terms of operation time, blood transfusion, chest drainage amount, duration of chest drainage and postoperative complications, no significant differences were found between the two groups (p > 0.05). The mean intraoperative blood loss of VATS group was less than thoracotomy group (79.0 ± 63.9 vs. 165 ± 94.9 ml, p = 0.04). In VATS group, the mean length of postoperative hospital stay was 6.0 ± 2.4 days, shorter than that in group thoracotomy (9.0 ± 3.5 days, p = 0.01).ConclusionsVATS was a feasible and safe method for the surgical treatment of MLS in selected patients when no severe calcified lymph nodes surrounding hilus pulmonis was observed by preoperative chest CT scan.

A comparison of Video‐Assisted Thoracoscopic Surgery with Open Thoracotomy for the Management of Chest Trauma: A Systematic Review and Meta‐analysis

“…We identified a total of 2,132 potentially relevant studies. After reviewing the titles, abstracts, and full text, 26 studies [17, 25–49] met the study inclusion criteria and were included for the final analysis (Supplementary Fig. 1).…”

“…In our study, only two studies evaluated pain intensity [30, 47] and length of incision [34, 36], respectively, so meta‐analysis was not performed on these two issues. But these studies showed that mean score of Visual Analog Scale was significantly lower [30, 47] and length of incision was significantly shorter for VATS [34, 36]. Our meta‐analysis also demonstrated that the amount of bleeding, transfusion volume during operation, and the total operation time were smaller or shorter for VATS, suggesting smaller wounds and smoother process.…”

“…VATS was increasingly accepted mainly due to the potential benefits of small wounds and less pain to patients [52]. In our study, only two studies evaluated pain intensity [30, 47] and length of incision [34, 36], respectively, so meta‐analysis was not performed on these two issues. But these studies showed that mean score of Visual Analog Scale was significantly lower [30, 47] and length of incision was significantly shorter for VATS [34, 36].…”