Video-assisted thoracoscopic surgery (VATS) lobectomy using a standardized anterior approach

Hansen, Henrik Jessen; Petersen, René Horsleben; Christensen, Merete

doi:10.1007/s00464-010-1355-9

Cited by 194 publications

(176 citation statements)

References 20 publications

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“…The different techniques varied from anterior, inferior to posterior approaches, using 2 to 5 ports (11,12). These surgeons were pioneers, but the next generation learned the technique under guided supervision.…”

Section: Discussionmentioning

confidence: 99%

Learning curve and established phase for uniportal VATS lobectomies: the Papworth experience

Bedetti¹,

Bertolaccini²,

Solli³

et al. 2017

J. Thorac. Dis.

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Background: Uniportal video-assisted thoracoscopy (VATS) has increasingly gained importance in the thoracic surgery scenario. The use of this technique can reduce postoperative pain and length of stay and gives the surgeon the same operative perspective as open surgery. Methods: We retrospectively analysed the data of 73 patients who underwent uniportal VATS lobectomies from November 2014 to December 2015 in our institution. We divided the patients in two groups (group 1: first 30 patients vs. group 2: established phase, 43 patients) to compare and evaluate the data regarding the learning curve. To explore evolution of learning curve, data were plotted to calculate Spearman's Rank-Order Correlation. R (version 3.2.3) was used for statistical analysis. Results: The median age was 69.9 (group 1) and 68.8 (group 2) years. Mean operative time was 84.9±33.0 (group 1) and 84.8±31.5 (group 2) minutes. The conversion rate was 13.3% in group 1 vs. 9.3% in group 2, showing a significant learning reduction (rho=0.590). Overall morbidity rate was 15.1%. The most common complication consisted in prolonged air leak. Interpolation line of complications showed a significant decrease due to learning curve (rho=0.676). The median length of stay was 4 days in group 1 vs. 3 days in group 2. The 30-day mortality was 3.3% in group 1 and 0% in group 2. Conclusions: The comparison between the groups showed that the median length of stay, operative time, conversion rate and 30-day mortality statistically significantly improved in the established phase. Also, complications like prolonged air leak were decreasing in the established phase. In conclusion, the uniportal VATS lobectomy technique can be performed safely from experienced surgeons without major complications and with an acceptable mortality rate.

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Section: Discussionmentioning

confidence: 99%

Learning curve and established phase for uniportal VATS lobectomies: the Papworth experience

Bedetti¹,

Bertolaccini²,

Solli³

et al. 2017

J. Thorac. Dis.

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“…In the "no-touch fissure" technique, the fused interlobar fissure is divided by a stapler after cutting of the pulmonary artery, vein, and bronchus. 5) This technique is efficient not only for avoiding the unexpected cutting of the displaced bronchus but also post-operative air leakage. The VATS approach allows excellent visualization of both the anterior and posterior hilum, even without the interlobar fissure completion, in comparison with direct vision through minithoracotomy.…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, we chose the "no-touch fissure" technique. 5) In this technique, no dissection is performed in the fissure. Instead, the interlobar fissure is completed by a stapler when most of the hilar structures have been divided.…”

Section: Case Reportmentioning

confidence: 99%

Video-Assisted Thoracic Surgery Lobectomy for Lung Cancer with Displaced B1+2

Asakura

Imanishi

Matsuoka

et al. 2014

ATCS

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A 52-year-old man was diagnosed with lung adenocarcinoma in the left upper lobe (c-T1bN0M0). Preoperative bronchoscopy revealed a displaced anomalous B 1+2 arising from the left main bronchus. Multiplanar reconstruction computed tomography showed that the displaced B 1+2 was located behind the left main pulmonary artery, and the interlobar fissure was largely fused. Video-assisted thoracic surgery (VATS) left upper lobectomy was performed successfully. The "no-touch fissure" technique was efficient not only for avoiding accidental cutting of the displaced bronchus but also post-operative air leakage. This is the first reported case of VATS lobectomy for lung cancer associated with a displaced B 1+2 .

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“…Our anterior technique achieves complete dissection of the subcarinal area [2,4] and follows the anatomical landmarks. Our aim was to report our anterior technique to share the knowledge.…”

Section: Replymentioning

confidence: 99%