A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy

Liu, Lunxu; Che, Guowei; Pu, Qiang; Ma, Lin; Wu, Yigen; Qi-wei, Kan; Zhuge, Xuepeng; Shi, Lu

doi:10.1016/j.suronc.2009.04.005

Cited by 94 publications

(85 citation statements)

References 11 publications

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“…All of enrolled patients were operated by a VATS procedure using the single-direction thoracoscopic technique that was described by Liu et al [17] through a three-portal access. A systematic mediastinal lymphadenectomy was performed on all of these patients, and a stapler line reinforcement was also utilized on their bronchial stumps.…”

Section: Methodsmentioning

confidence: 99%

Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study

Zhou

et al. 2017

BMC Surg

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BackgroundBody surface area (BSA) is a biometric unit to measure the body size. Its clinical significance in video-assisted thoracoscopic surgery (VATS) was rarely understood. We aimed to estimate the predictive value of BSA for surgical complications following VATS anatomical resections for lung adenocarcinoma (LAC).MethodsA single-center retrospective analysis was performed on the consecutive patients between July 2014 and January 2016 in our institution. The differences in mean BSA values were evaluated between groups of patients classified by the development of postoperative surgical complications (PSCs), overall morbidity and cardiopulmonary complications, respectively. Receiver operating characteristic (ROC) analysis was performed to determine a threshold value of BSA on prediction of PSC occurrence. A multivariate logistic-regression model involving this optimal cut-off value and other significant parameters was established to identify the predictors for PSCs.ResultsDuring the study period, a total of 442 patients undergoing VATS anatomical resections for LAC were enrolled in this study. There were 135 patients developed with one or more complications (rate = 30.5%). PSCs occupied the largest percentages of all these complications (n = 81, rate = 18.3%). The mean BSA in PSC group was significantly higher than that in non-PSC group (1.76 ± 0.15 m2 vs 1.71 ± 0.16 m2; P = 0.016). No difference was found in mean BSA values between groups classified by any other complication. The ROC analysis determined a BSA value of 1.68 m2 to be the threshold value with the maximum joint sensitivity of 72.8% and specificity of 48.5%. Compared to patients with BSA ≤ 1.68 m2, patients with BSA > 1.68 m2 had significantly higher incidences of prolonged air leak (P = 0.006) and chylothorax (P = 0.004). Further multivariate logistic-regression analysis indicated that BSA > 1.68 m2 could be an independent risk factor for PSCs (odds ratio: 2.03; P = 0.025).ConclusionsBSA is an excellent categorical predictor for surgical complications following VATS anatomical resections for LAC. It may be considered when informing patients about surgical risks and selecting cases in the early learning curve. Large-scale and multi-institutional studies are expected to confirm and modify our findings in the future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12893-017-0264-4) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study

Zhou

et al. 2017

BMC Surg

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“…VATS lobectomy in our center was carried out with the "single-direction" technique as we previously described (11), which is also known as a "fissure-last" technique. Systematic nodal dissection was accomplished using the "non-grasping" method for all the patients (12).…”

Section: Surgical Techniquementioning

confidence: 99%

Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

et al. 2017

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Background: Prolonged air leak (PAL) is one of the most common postoperative complications after pulmonary resection. The aim of this study was to reveal the incidence and risk factors of PAL in videoassisted thoracic surgery (VATS) lung cancer resection, and to evaluate the effect of PAL on postoperative complications, postoperative length of stay (PLOS), and medical costs. Methods: Continuous patients who underwent VATS major pulmonary resection for lung cancer betweenJanuary 2014 and December 2015 were studied. Clinical data of these patients were obtained from the Western China Lung Cancer Database. PAL was defined as air leak more than 5 days after surgery. The risk factors for PAL were analyzed, as well as the effect of PAL on postoperative clinical recovery.

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“…This also make it easier to perform VATS sleeve lobectomy. 11 However, the needle holder could only be induced through utility incision when anastomosis, and this restricted the angle of it, which may prolonged the anastomotic time (the mean anastomotic time in our cases was 63 min). Live with disease free…”

Section: About the Bronchial Anastomosismentioning

confidence: 88%

Initial experience of sleeve lobectomy under complete video‐assisted thoracic surgery

Yan

Liu

et al. 2017

Asia-Pac J Clncl Oncology

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Purpose: Review the initial results of a single-center complete video-assisted thoracoscopic surgery (VATS) sleeve lobectomy and discuss the key procedure of this operation, in addition to its safety and feasibility. Methods:Retrospectively analyze the perioperative data of 11 patients who accepted complete VATS sleeve lobectomy between May 2013 and Jun 2017 in Peking University Third Hospital, try to evaluate the safety of this procedure. All the patients were followed up and their oncological recurrence and metastasis were observed, and feasibility of VATS sleeve lobectomy for lung cancer was evaluated.Results: All of the 11 cases underwent complete VATS sleeve lobectomy successfully and there is no conversion to thoracotomy. The mean operative time was 338 min (range from 243 to 511 min), the mean time of bronchial anastomotic was 63 min (range from 40 to 96 min), the mean blood loss was 205 mL (range from 50 to 400 mL), and the mean number of lymph nodes dissected is 22.1.There was no other complication except one patient suffered from high-risk pulmonary embolism, and no anastomotic leakage and stricture was found. The mean hospital stay postoperation was 8.7 days. The time of follow-up was between 2 and 38 months, only one out of the 11 cases died of bone metastasis, and the other 10 survived till now. One of these 10 patients had local recurrence 24 months after operation, and one suffered adenocarcinoma of esophageal-gastric junction at 15 months postoperation. The rest of eight patients all survived to June 2017 and no local recurrence and metastasis was found. The mean survival time was 14.8 months. Conclusion:Complete VATS sleeve lobectomy is a safe and feasible procedure, but the advantage of perioperative and long-term survival need prospective randomized controlled large sample trial to be confirmed.

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A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy

Cited by 94 publications

References 11 publications

Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study

Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study

Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

Initial experience of sleeve lobectomy under complete video‐assisted thoracic surgery

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