F-105is Uniportal Thoracoscopic Surgery a Feasible Approach for Advanced Stages of Non-Small Cell Lung Cancer?

González-Rivas, Diego; Fieira, Eva; Delgado, María Isabel; Méndez, Lucía; Fernández, Ricardo; Paradela, Marina; García, José Ángel Brandariz; Torre, Mercedes de la

doi:10.1093/icvts/ivt288.105

Cited by 57 publications

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“…The major lung resection with radical lymphadenectomy for non-small cell lung cancer, was the first report by Dr. Gonzalez Rivas from Coruña University hospital in Spain, followed by complex uniportal VATS lung resection including lobectomy (4), pneumonectomy (5), segmentectomy (6), bronchoplastic procedures, chest Wall resection and a lobectomy in a non-intubated patient (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery, Argentinian experience

Bondulich¹,

Rivas²

2017

J. Vis. Surg.

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The acceptance of uniportal video-assisted thoracoscopic surgery (VATS) for minor and major thoracic procedures is growing in South America. This study presents the experience with uniportal VATS in Buenos Aires, Argentina. In a retrospective study, 181 patients were operated with uniportal VATS technique between December 2013 and October 2016. Uniportal procedures included minor and major procedures.Uniportal VATS were analyzed en terms of morbidity, mortality, conversion rate, hospital stay. A total of 181 patients were analyzed. 59% were males and 41% females. The mean age was 58.

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Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery, Argentinian experience

Bondulich¹,

Rivas²

2017

J. Vis. Surg.

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“…In the treatment of lung cancer, this has been addressed to some extent within thoracic surgery and pulmonology with the most recent clinical guidelines (40). However, the terminology and use of non-thoracic surgeons as the decision-maker for determining the patient's eligibility for surgery may require re-exploration now that uniportal and related non-intubated anesthetic approaches have been used safely and effectively on even the frailest patients (32,41).…”

Section: Philosophical Shiftmentioning

confidence: 99%

“…H o w e v e r , d e s p i t e t h e m u l t i p l e a d v a n t a g e s o f conventional multiport or uniportal VATS compared to thoracotomy such as decreased postoperative pain, decreased hospitalization, diminished inflammatory response or faster access to chemotherapy, the uniportal VATS approach for advanced stages of lung cancer is still infrequently undertaken (41). The main reasons for this low adoption of the technique are concerns about an intraoperative thoracoscopic major bleeding event or the technical challenges of performing a radical oncologic resection by uniportal VATS in advanced cases (51).…”

Section: The Role Of the Uniportal Technique For Advanced Casesmentioning

confidence: 99%

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Uniportal thoracoscopic surgery: from medical thoracoscopy to non-intubated uniportal video-assisted major pulmonary resections

González-Rivas¹

2016

Ann. Cardiothorac. Surg.

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The development of thoracoscopy has more than one hundred years of history since Jacobaeus described the first procedure in 1910. He used the thoracoscope to lyse adhesions in tuberculosis patients. This technique was adopted throughout Europe in the early decades of the 20 th century for minor and diagnostic procedures.It is only in the last two decades that interest in minimally invasive thoracic surgery was reintroduced by two key technological improvements: the development of better thoracoscopic cameras and the availability of endoscopic linear mechanical staplers. From these advances the first video-assisted thoracic surgery (VATS) major pulmonary resection was performed in 1992. In the following years, the progress of VATS Currently, experts in the technique are able to use uniportal VATS to encompass the most complex procedures such as bronchial sleeve, vascular reconstructions or carinal resections. In contrast, non-intubated and awake thoracic surgery techniques, described since the early history of thoracic surgery, peaked in the decades before the invention of the double lumen endotracheal tube and have failed to gain widespread acceptance following their re-emergence over a decade ago thanks to the improvements in VATS techniques.

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“…Now growing evidences show the feasibility and safety of uniportal VATS lobectomy for lung cancer (1), although the long-term outcomes are need to be tested in the future. Here we demonstrate a right upper lobectomy with systemic lymphadenectomy for lung cancer by using uniportal VATS approach.…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracic surgery right upper lobectomy with systemic lymphadenectomy

Han

Xiang

et al. 2016

ASVIDE

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IntroductionAs one of the minimal invasive surgery approach for thoracic surgery, uniportal video-assisted thoracic surgery (VATS) has been made great progress with the development of surgical technic and instruments. Now growing evidences show the feasibility and safety of uniportal VATS lobectomy for lung cancer (1), although the long-term outcomes are need to be tested in the future. Here we demonstrate a right upper lobectomy with systemic lymphadenectomy for lung cancer by using uniportal VATS approach. Clinical dataA 51-year-old man had a 3-month history of right lung shadow in X-ray. After 2 months of anti-infective therapy, X-ray showed no significant changes, then a nodule (2.5 cm in diameter) in right upper lobe was detected by CT. PET-CT revealed that the nodule was hypermetabolic with no other metastasis. The result of fine needle aspiration (FNA) verified the nodule was adenocarcinoma. After preoperative preparation, the patient was underwent uniportal VATS lobectomy with systemic lymphadenectomy. Postoperative pathological report suggested the stage of the tumor was T1bN0M0 (stage IA). Operative techniquesAfter being anesthetized with double-lumen endotracheal intubation, the patient was positioned in left lateral decubitus position. The uniportal incision located in the 5th intercostal space, anterior to latissimus dorsi and posterior to pectoralis major. We used a lap-protector to avoid contamination. Both the operator and the camera holder stand on the ventral side. In this video, the procedures were as followed (Figure 1):• Exploration of chest revealed no pleural adhesions, no pleural effusion and no pleural nodules; • After cutting open the mediastinal pleura form horizontal fissure to right hilus pulmonis, the operator performed the dissection of level 10 and level 11 lymph nodes, which would facilitate subsequent dissection of vasa publicas; • After remove of level 10 lymph nodes, we could identify the borders of level 10 lymph nodes: superior vena cava, arch of azygos vein, upper lobe pulmonary artery and upper lobe pulmonary vein; • Dissection of level 11 lymph nodes and oblique fissure from ventral to dorsal would facilitate the exposure of the posterior ascending artery; • The posterior ascending artery was well exposed by dorsal to cranial in order to expose the upper lobe bronchus. After this step, the mediastinal pleura around the upper lobe was entirely cut open; • After dissection of the lymph nodes around it, the upper lobe bronchus was well dissociated by forceps and then transected by a stapler; • It is easy for operator to expose and cut off the apical segment artery after transection of the upper lobe bronchus; • After dissection of the lymph nodes between pulmonary artery truck and bronchus, operator transected the remanent upper lobe pulmonary veins and anterior segment artery by one stapler; • Next to use a bag to take the specimen out, operator began to dissect mediastinal lymph nodes by using hook electrode and harmonic scalpel to minimize blood; • After performing an ent...

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F-105is Uniportal Thoracoscopic Surgery a Feasible Approach for Advanced Stages of Non-Small Cell Lung Cancer?

Cited by 57 publications

References 0 publications

Uniportal video-assisted thoracoscopic surgery, Argentinian experience

Uniportal video-assisted thoracoscopic surgery, Argentinian experience

Uniportal thoracoscopic surgery: from medical thoracoscopy to non-intubated uniportal video-assisted major pulmonary resections

Uniportal video-assisted thoracic surgery right upper lobectomy with systemic lymphadenectomy

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