Pulmonary Function After Lobectomy: Video-Assisted Thoracoscopic Surgery Versus Muscle-Sparing Mini-thoracotomy

Abstract

Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars. Pulmonary function tests were performed a week before surgery and 3 months after surgery. There were 14 males and 11 females in VATS lobectomy and 32 males and 30 females in mini-thoracotomy lobectomy. For lobe location (right upper/right lower/left upper/left lower), there were 12/1/8/4 in VATS lobectomy and 16/19/13/14 in mini-thoracotomy lobectomy, respectively. The percent predicted postoperative forced vital capacity (FVC) (postoperative FVC/predicted postoperative FVC × 100) (110 ± 15 %) of VATS lobectomy was significantly higher than that (101 ± 16 %) of mini-thoracotomy lobectomy ( = 0.0124). The percent predicted postoperative forced expiratory volume in 1 s (FEV1) (postoperative FEV1/predicted postoperative FEV1 × 100) (110 ± 15 %) of VATS lobectomy was not significantly higher than that (104 ± 15 %) of mini-thoracotomy lobectomy ( = 0.091). Multiple regression analysis revealed that operative procedure (VATS lobectomy or mini-thoracotomy lobectomy) was the only significant variable contributing to percent predicted postoperative FVC ( = 0.0073) and percent predicted postoperative FEV1 ( = 0.0180). Postoperative FVC after VATS lobectomy is better than after mini-thoracotomy lobectomy.

Classification and Diagnosis of Pulmonary Nodules in Thoracic Surgery Using CT Image Segmentation Algorithm

“…67 patients were diagnosed with invasive PN and required lobectomy. In contrast to the study of Usuda et al [15], the operative time (27.5.2 ± 4.5 min) was shortened, the intraoperative blood loss (51.6 ± 13.8 mL) was decreased, and the length of hospital stay (6.4 ± 1.2 days) was also decreased. e preoperative positioning in this study can stretch the shrunken tissues and facilitate surgical resection.…”

Comparison of Postoperative Quality of Life and Pain with and without a Metal Rib Spreader in Patients Undergoing Lobectomy through Axillary Mini-Thoracotomy for Stage I Lung Cancer

“…While a large number of reports have compared the perioperative or long-term oncological outcomes between VATS and thoracotomy, 6,7,24) studies comparing VATS and mini-thoracotomy remain limited. [25][26][27][28][29] Among these studies, they reported that VATS is less painful, 27,29) introduces less acute surgical stress, 26,28) and retains more pulmonary function than mini-thoracotomy, 25) which contradicted our results. This could be attributed to our VA/noMRS procedure, which included intercostal muscle separation and minimal rib spreading.…”

Surgical treatment of non-cystic fibrosis bronchiectasis in Central Europe

“…It is associated with reduced postoperative pain and increased quality of life (32,33) as well as shortened length of hospital stay (34), and represents an ideal method for older and multimorbid patients otherwise not amenable for conventional surgery. It is better tolerated owing to less chest wall injury and better preservation of postoperative lung function (35).…”