Analysis of Unexpected Conversion to Thoracotomy During Thoracoscopic Lobectomy in Lung Cancer

Byun, Chun Sung; Lee, Sung-Soo; Kim, Dae Joon; Lee, Jin Gu; Lee, Chang Young; Jung, Inkyung; Chung, Kwansoo

doi:10.1016/j.athoracsur.2015.04.032

Cited by 64 publications

(73 citation statements)

References 23 publications

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“…In the present study, the most common cause of conversion was peribronchial or perivascular adhesion (25/55, 45.5%), which is consistent with what has previously been reported (8,10,19,20). The second cause of conversion was bronchial or vascular injury (12/55, 21.8%) that frequently lead to uncontrolled bleeding from pulmonary vessels.…”

Section: Discussionsupporting

confidence: 81%

“…Conversely, almost all patients (12/13, 92.3%) with PLN or PCS but without FDG uptake at PET/CT, even when it showed calcification, completed VATS lobectomy (Figure 2). According to previous studies, hilar calcification on preoperative CT scans has been regarded as a convincing predictor for conversion due to peribronchial anthracofibrosis (8)(9)(10). However, our data highlight that some patients with calcified PLN or PCS may be suitable candidates for VATS lobectomy as long as they do not have concurrent FDG uptake.…”

Section: Discussioncontrasting

confidence: 48%

“…To avoid these post-operative complications, it is imperative to identify the preoperative risk factors to reduce unexpected thoracotomy conversion. There are several studies evaluating the role of imaging studies in predicting conversion, and they revealed that hilar lymph node calcification on preoperative chest CT is an important factor for predicting conversion (8)(9)(10). They evaluated the relationship between the presence of calcified lymph node and conversion, but they did not describe other CT findings with regard to peribronchial fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Several demographic and clinical factors such as older age, history of the granulomatous disease, current COPD or smoker, and reduced forced expiratory volume in 1 second (FEV 1 ) have been identified to be predictors of intraoperative conversion (7)(8)(9). Additionally, recent studies revealed that computed tomography (CT) images with hilar lymph node calcification could predict intraoperative conversion, which was associated with adhesion of lymph nodes to hilar structures and subsequent difficulty in the dissection of hilum (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, recent studies revealed that computed tomography (CT) images with hilar lymph node calcification could predict intraoperative conversion, which was associated with adhesion of lymph nodes to hilar structures and subsequent difficulty in the dissection of hilum (8)(9)(10). However, even lymph nodes without calcification on CT images revealed extensive perihilar granulomatous inflammation during the operation, which required conversion to thoracotomy (9,10).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Predictors of conversion to thoracotomy during video-assisted thoracoscopic surgery lobectomy in lung cancer: additional predictive value of FDG-PET/CT in a tuberculosis endemic region

Lim¹,

Shin²,

Lim³

et al. 2017

J. Thorac. Dis.

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Section: Discussionsupporting

confidence: 81%

Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Predictors of conversion to thoracotomy during video-assisted thoracoscopic surgery lobectomy in lung cancer: additional predictive value of FDG-PET/CT in a tuberculosis endemic region

Lim¹,

Shin²,

Lim³

et al. 2017

J. Thorac. Dis.

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Is Calcification in the Regional Lymph Nodes a Benign Feature in Patients with Lung Cancer?

et al. 2019

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Background Calcified lymph nodes (LNs) on computed tomography (CT) in patients with lung cancer are generally considered to be a benign feature. However, few studies have evaluated the pathological status of such calcified LNs. We investigated the clinicopathological findings of patients with calcified LNs on preoperative CT who underwent operation for lung cancer and assessed the frequency of metastasis to calcified LNs as well as the risk factors associated with such metastases. Methods This was a retrospective study of 72 consecutive patients with calcified LNs detected on preoperative CT who underwent pulmonary resection for primary lung cancer between 2011 and 2013. A total of 354 LN stations including 101 LN stations with calcified LNs were evaluated. ResultsThe frequency of metastasis to calcified LNs was 19.4% (14 of 72 patients) on a per-person basis and 18.8% (19 of 101 stations) on a per-nodal station basis. When the size of calcification was major ([5 mm), the frequency of metastasis to such calcified LNs was significantly lower than when it was minor (^5 mm) on a per-nodal station basis (11.1% vs 27.7%, P = 0.043). Furthermore, when the size of calcification was major and the status of LN stations with calcified LNs was single, there was no metastasis to such LN stations (0 of 26 stations). Conclusions The frequency of metastasis to calcified LNs was about 20% on both a per-person and a per-nodal station basis. Although calcified LNs as well as non-calcified LNs should be dissected during operation, dissection of a single LN station with calcification, particularly major calcification, can be omitted.

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A Diaphragmic Traction Suture Increases Pleural Cavity Volume and Surgical Field Overview During Video‐Assisted Thoracoscopic Surgery

2021

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Objectives An elevated hemidiaphragm may impair surgical field overview during video assisted thoracoscopic surgery (VATS) and may consequently jeopardize a safe surgical procedure or prolong the duration of surgery. The aim of this study was to evaluate if tension applied to a diaphragmatic suture improves the surgical field overview. Methods Following informed consent and at the surgeon's discretion during elective VATS procedures, a single stitch was placed at the posterior tendinous border of the diaphragm and retracted through the camera port. The surgical field overview was evaluated using a numeric rating scale (1-10) by the surgeon before and after applying tension during the procedure, and later by 9 VATS surgeons ([ 10 years' experience) using video recordings. Results During a 4-month period, 43 patients scheduled for elective VATS by two surgeons gave informed consent to participate. The hemidiaphragm was elevated to such an extent in 27 patients that the surgeon placed a diaphragmatic stitch suture. When tension was applied to the suture, surgical field overview improved significantly (p \ 0.001). Conclusion A diaphragmatic traction suture improves surgical field overview in selected patients with elevation of the hemidiaphragm. This simple procedure may facilitate VATS in patients with impaired surgical field overview and consequently improve safety during VATS. Clinical Trial Number http://ClinicalTrials.gov (No. NCT04837950).

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Analysis of Unexpected Conversion to Thoracotomy During Thoracoscopic Lobectomy in Lung Cancer

Cited by 64 publications

References 23 publications

Predictors of conversion to thoracotomy during video-assisted thoracoscopic surgery lobectomy in lung cancer: additional predictive value of FDG-PET/CT in a tuberculosis endemic region

Predictors of conversion to thoracotomy during video-assisted thoracoscopic surgery lobectomy in lung cancer: additional predictive value of FDG-PET/CT in a tuberculosis endemic region

Is Calcification in the Regional Lymph Nodes a Benign Feature in Patients with Lung Cancer?

A Diaphragmic Traction Suture Increases Pleural Cavity Volume and Surgical Field Overview During Video‐Assisted Thoracoscopic Surgery

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