A solution for fissure-less fissure-last both upper and lower video-assisted thoracic surgery lobectomies?

Akar, Firas Abu; Nachira, Dania; Meacci, Elisa; Asbeh, Yousef Abu; Shaqqura, Bisanne; Margaritora, Stefano

doi:10.21037/jtd.2018.12.41

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…41 Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach to gain access to the chest as an alternative to the more morbid open posterolateral or anterior thoracotomy. 41,42 Despite this advance, the morbidity rate associated with VATS remains as high as 25% to 35% even in high-volume top-quality centers. 41,43 Patients with incomplete pulmonary fissures have significantly higher overall morbidity after VATS lobectomy than is observed among patients with well-developed pulmonary fissures, including an increased risk of pneumonia, atelectasis, subcutaneous air, pneumothorax, and atrial arrhythmia.…”

Section: Lobectomymentioning

confidence: 99%

“…Currently, lobectomy is the criterion standard for treatment of operable NSCLC with relative safety to allow preservation of pulmonary function 41. Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach to gain access to the chest as an alternative to the more morbid open posterolateral or anterior thoracotomy 41,42. Despite this advance, the morbidity rate associated with VATS remains as high as 25% to 35% even in high-volume top-quality centers 41,43.…”

Section: Lobectomymentioning

confidence: 99%

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Accessory and Incomplete Lung Fissures

Bayter

Lee

Grage

et al. 2020

Journal of Thoracic Imaging

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Objective: This article reviews the anatomy, histology, and disease processes of pulmonary fissures, with emphasis on clinical implications of accessory and incomplete fissures. Conclusion:Accessory and incomplete pulmonary fissures are often overlooked during routine imaging but can have profound clinical importance. Knowledge of fissure anatomy could improve diagnostic accuracy and inform prognosis for oncologists, interventional pulmonologists, and thoracic surgeons.

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Section: Lobectomymentioning

confidence: 99%

Section: Lobectomymentioning

confidence: 99%

Accessory and Incomplete Lung Fissures

Bayter

Lee

Grage

et al. 2020

Journal of Thoracic Imaging

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“…Current evidence from the literature clearly shows that lung IFs increase the difficulty of lung surgery and increase the likelihood of prolonged air leakage and hospital stay during lung surgery ( 13 , 14 ). In lobectomy, fissure-last approach was more recommended for patients with chronic obstructive pulmonary disease or complex cases with lesions near the hilum ( 15 , 16 ). Segmental resection as a sublobar resection, the data is not clear.…”

Section: Introductionmentioning

confidence: 99%

The safety and efficacy of the fissure-first approach in lung segmentectomy for patients with incomplete fissures

Zhu,

Zheng,

Chen

et al. 2024

Front. Oncol.

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BackgroundLung segmentectomy has gained much more attention as an important surgical method for treating early-stage lung cancer. However, incomplete fissures increase the difficulty of lung segmentectomy. The aim of this study was to analyze the safety and efficacy of the fissure-first approach in precision resection of lung segments for patients with incomplete fissures.MethodsThe clinical data of patients with incomplete fissures who underwent lung segmentectomy were retrospectively analyzed. Date was divided into fissure-first approach in lung segmentectomy group (group A) and fissure-last approach in lung segmentectomy group (group B). The general linear data, operation times, intraoperative adverse events, postoperative recovery dates and complications were compared.ResultsA total of 122 patients with complete clinical data were included. Patients in group B had more COPD (p < 0.05), and the lesions in group A were more closely related to the hilum of the lung (p < 0.05). Compared to Group B, Group A achieved better surgical outcomes, such as operation time, postoperative hospital stays, intraoperative bleeding, number of intrapulmonary lymph nodes sampled, counts of resected subsegments (except the upper lobe of the right lung), and rate of conversion to thoracotomy (all p < 0.05).ConclusionThe fissure-first approach is a safe and effective surgical approach in lung segmentectomy for patients with incomplete fissures. This approach can reduce the counts of resected subsegments and improve techniques in lung segmentectomy for patients with lung incomplete fissures.

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