&lt;p&gt;Comparison of Double Sleeve Lobectomy by Uniportal Video-Assisted Thoracic Surgery (VATS) and Thoracotomy for NSCLC Treatment&lt;/p&gt;

Wu, Liang; Wang, Hao; Cai, Haomin; Jiang, Fan; Jiang, Gening; He, Yayi; Jiang, Lei

doi:10.2147/cmar.s226459

Cited by 16 publications

(36 citation statements)

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“…As such, the experience required to undertake complex uniportal VATS sleeve lobectomies is even greater (6). Uniportal VATS complex sleeve lung resections need to follow the conventional surgical techniques for uniportal VATS sleeve lung resection, which have been summarized in previous articles (7)(8)(9)(10)(11)(12). However, special techniques should be applied according to the characteristics of the complex sleeve surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment methods for blood vessels, pulmonary fissures, and lymph nodes were the same as for complete thoracoscopic lobectomy. The specific steps were as follows: sleeve bronchial resection, anastomosis trimming, and frozen pathological examination to ensure that there was no tumor infiltration at the incision margin; then 3-0 (tracheal and leaf bronchial anastomosis) or 4-0 (segmental bronchial anastomosis) non-absorbable sutures (prolene, Covidien Inc., USA) were sutured continuously in clockwise and counterclockwise directions from the medial wall, respectively, sutured from the back of the anastomotic site to the front, knotted after suturing, and tested through flushing for no leakage even when the airway pressure was maintained at 30 cmH 2 O. Uniportal VATS special sleeve lung resection needs to follow the conventional surgical technique of uniportal VATS sleeve lung resection, which has been summarized in previous articles (7)(8)(9)(10)(11)(12).…”

Section: Surgical Techniquementioning

confidence: 99%

“…From June 2016 to April 2020, a total of 183 cases of uniportal VATS sleeve pulmonary resections were performed by the single surgical team at the thoracic surgery department of the Shanghai Pulmonary Hospital. Of these, 163 cases of the upper, middle, and lower lobe sleeve resections have already been analyzed in previous reports (7)(8)(9)(10)(11)(12). This article aims to analyze the remaining 20 cases, which we categorize as "complex sleeve lung resections ".…”

Section: Introductionmentioning

confidence: 99%

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Surgical techniques and outcome analysis of uniportal video-assisted thoracic surgery complex sleeve lung resection: a 20 case-series study

Soultanis

Jiang

2021

J Thorac Dis

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Background: Our study aims to explore the feasibility of uniportal video-assisted complex sleeve lung resection and summarize the surgical techniques and clinical outcomes. Methods: From June 2016 to April 2020, a total of 20 complex sleeve pulmonary and distal tracheal resections were performed by the single surgical team at the Thoracic Surgery Department of the Shanghai Pulmonary Hospital. We defined cases as complex sleeve pulmonary resections if they required pulmonary segment sleeve resection, extended sleeve resection (lobectomy plus segmentectomy of the remaining lobe), sleeve pneumonectomy, lobectomy plus carinoplasty or neo-carina construction, pulmonary-sparing main bronchus resection plus carina reconstruction, and distal trachea resection with end to end anastomosis. Results: The 20 cases comprised lung squamous cell carcinoma (n=11), lung adenocarcinoma (n=2), hamartoma (n=3), adenoid cystic carcinoma (n=2), carcinoid tumor (n=1), and pleomorphic carcinoma (n=1).The average blood loss during the operation was 250±126.17 mL (50-800 mL). The average operation time was 192.0±61.1 minutes. The average number of lymph node stations removed was 5.82±1.33, including station seven in all cases, and the median number of lymph nodes removed was 4.18±5.89. On the day of surgery, the drainage volume was 266±192.01 mL. The mean postoperative hospital stay was 5.37±1.86 days.Twelve of the 16 patients diagnosed with malignancy received postoperative chemotherapy. Granuloma formation at the anastomosis level led to stenosis in one case, and tumor recurrence occurred in one case. Broncho-esophageal fistula occurred in one patient after radiochemotherapy. The postoperative follow-up time was 15.6±10.7 months. The 30-day mortality was zero, and at one-year follow-up, only one patient had died of metastatic disease after the operation. Conclusions: Uniportal video-assisted complex sleeve pulmonary resections are feasible when conducted by experienced teams.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical techniques and outcome analysis of uniportal video-assisted thoracic surgery complex sleeve lung resection: a 20 case-series study

Soultanis

Jiang

2021

J Thorac Dis

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“…Since sleeve lobectomy via thoracoscopy was firstly attempted in 2002 (12), several researches reported the successful implementation of this procedure in hand of experienced surgeons (13)(14)(15)(16). Recently, a series of comparative studies further identified the feasibility of thoracoscopic sleeve lobectomy for centrally located NSCLC (17)(18)(19)(20)(21)(22). However, its operative safety and oncologic efficacy compared to thoracotomy sleeve lobectomy remain controversial.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of thoracoscopic versus thoracotomy sleeve lobectomy

Zhong¹,

Wang²,

Hu³

et al. 2020

J Thorac Dis

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Background: Operative safety and oncologic adequacy of thoracoscopic sleeve lobectomy remain controversial. As such, the purpose of this meta-analysis was to evaluate evidence comparing thoracoscopy and thoracotomy in sleeve lobectomy for centrally located non-small cell lung cancer (NSCLC). Methods: Electronic searches of PubMed and Web of Science databases were undertaken from inception to March 2020. Comparative studies about thoracoscopic and thoracotomy sleeve lobectomy, with evaluation for perioperative outcomes and oncological results were identified. The following outcomes were measured in this meta-analysis: operating time, blood loss, numbers of lymph node, postoperative hospital stay, chest drainage time, postoperative complication rate, mortality, overall survival (OS). The standardized difference (SMD), relative risk (RR) and hazard ratio (HR) with 95% confidence intervals (CI) were pooled using Stata software.Results: Six studies generating 281 thoracoscopy and 369 thoracotomy cases were finally included. There was no significant difference in intraoperative blood loss, number of resected lymph nodes, chest drainage time, postoperative complication rate and mortality between two groups. However, thoracoscopic sleeve lobectomy was associated with longer operation time (SMD 0.59, 95% CI: 0.14 to 1.03, P=0.010). And shorter postoperative hospital stays (SMD −0.24, 95% CI: −0.51 to 0.03, P=0.078) were observed in the thoracoscopy group with marginal significance. Furthermore, sleeve lobectomy via thoracoscopy could achieve comparable OS compared to that via thoracotomy (HR 0.69, 95% CI: 0.38 to 1.00; P<0.001). In addition, there were no evident publication bias in all observational outcomes.Conclusions: Current evidence suggests that thoracoscopic sleeve lobectomy is a safe and efficient surgical procedure for centrally located NSCLC, with comparable perioperative outcomes and equivalent oncological results compared to thoracotomy sleeve lobectomy.

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“…Video-assisted thoracic surgery (VATS) has been widely applied to treat lung cancer (50,51). A large number of previous studies have demonstrated that compared with thoracotomy, thoracoscopic lobectomy is characterized by less trauma, faster postoperative recovery and fewer complications (52).…”

Section: Surgerymentioning

confidence: 99%

The application of artificial intelligence in lung cancer: a narrative review

Zhang¹,

Meng²,

Cai³

et al. 2021

Transl Cancer Res TCR

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Objective: This review was conducted to systematically summarize the progress made by artificial intelligence technology in early screening based medical imaging, pathological diagnosis, genomics inspection, prognostic evaluation, and individual treatment of lung cancer.Background: Lung cancer has a high mortality rate in China, which is closely related to the fact that most lung cancer patients are not diagnosed until the malignancy is advanced. Challenges remain in the early detection, accurate diagnosis, monitoring and individual treatment of lung cancers. Artificial intelligence has developed to process large amounts of data, from clinical presentations to physiological images, which is essential for solving the complex issues with clinical medicine. Increasing evidence has suggested that artificial intelligence technology provides novel, promising strategies for the diagnosis and treatment of lung cancer.Methods: A review of literature was conducted in PubMed, EMBASE and Cochrane to identify the latest research on artificial intelligence and lung cancer, and ultimately to generate a narrative review.Conclusions: Artificial intelligence plays an important role in the imaging inspection, histopathology examination and genomics inspection of lung cancer. In addition, artificial intelligence has the ability to detect a small number of biomarkers, which is conducive to lung cancer monitoring. Moreover, the intelligent treatment of lung cancer has gradually become the trend of future development, whether in internal medicine or surgical treatment. It is believed that artificial intelligence could improve the early diagnosis of lung cancer and assist doctors in treating lung cancer patients individually.

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<p>Comparison of Double Sleeve Lobectomy by Uniportal Video-Assisted Thoracic Surgery (VATS) and Thoracotomy for NSCLC Treatment</p>

Cited by 16 publications

References 36 publications

Surgical techniques and outcome analysis of uniportal video-assisted thoracic surgery complex sleeve lung resection: a 20 case-series study

Surgical techniques and outcome analysis of uniportal video-assisted thoracic surgery complex sleeve lung resection: a 20 case-series study

A systematic review and meta-analysis of thoracoscopic versus thoracotomy sleeve lobectomy

The application of artificial intelligence in lung cancer: a narrative review

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