Video-assisted thoracic bronchial sleeve lobectomy with bronchoplasty for treatment of lung cancer confined to a single lung lobe: a case series of Chinese patients

Abstract

BackgroundThe outcomes of video-assisted thoracic bronchial sleeve lobectomy (VABSL), a minimally invasive video-assisted thoracoscopic (VATS) lobectomy, are mostly unknown in Chinese patients.ObjectivesTo investigate operative and postoperative outcomes of VABSL in a cases series of Chinese patients with lung cancer.MethodsRetrospective study of 9 patients (male:female 8:1; mean age 59.4 ± 17.6 years, ranging 21–79 years) diagnosed with lung cancer of a single lobe, treated with VABSL between March 2009 and November 2011, and followed up for at least 2 months (mean follow-up: 14.17 ± 12.91 months). Operative outcomes (tumor size, operation time, estimated blood loss and blood transfusion), postoperative outcomes (intensive care unit [ICU] stay, hospitalization length and pathological tumor stage), death, tumor recurrence and safety were assessed.ResultsPatients were diagnosed with carcinoid cancer (11.1%), squamous carcinoma (66.7%) or small cell carcinoma (22.2%), affecting the right (77.8%) or left (22.2%) lung lobes in the upper (55.6%), middle (11.1%) or lower (33.3%) regions. TNM stages were T2 (88.9%) or T3 (11.1%); N0 (66.7%), N1 (11.1%) or N2 (22.2%); and M0 (100%). No patient required conversion to thoracotomy. Mean tumor size, operation time and blood loss were 2.50 ± 0.75 cm, 203 ± 20 min and 390 ± 206 ml, respectively. Patients were treated in the ICU for 18.7 ± 0.7 hours, and overall hospitalization duration was 20.8 ± 2.0 days. No deaths, recurrences or severe complications were reported.ConclusionsVABSL surgery is safe and effective for treatment of lung cancer by experienced physicians, warranting wider implementation of VABSL and VATS training in China.

Fast-track surgery versus conventional perioperative management of lung cancer-associated pneumonectomy: a randomized controlled clinical trial

“…In Chinese medical centers, length of hospital stay includes not only the essential times of preparation, operation, and postoperative monitoring in intensive care unit but also major part of the rehabilitation. Importantly, the duration of hospitalization in this FTS was shorter than that of similar studies, even less than those known to have less postoperative complications than that of the present study [31]. As a result, the readmission rate in this study was generally lower, which supports adoption of the FTS in NSCLC pneumonectomy.…”

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

“…We believe that by using this method, the anastomotic tension can be efficiently controlled and anastomotic complications can thus be reduced. Postoperative characteristics such as the anastomosis time, blood loss volume, drainage duration, and hospital stay in this study were comparable with those reported by other authors (5,10,13,15). Yildizeli et al (18) reported an anastomotic complication rate of 6.4%, including bronchopleural fistulas, bronchial stenosis, local necrosis, bronchovascular fistulas, and bronchial rupture.…”

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

“…Xu et al showed the average operative blood loss was 207±96 mL 29. Another study in a Chinese population reported that as 390±206 mL 30. A multicenter study showed that the median operative blood loss was 224 mL 25.…”