Right sleeve pneumonectomy via uniportal video-assisted thoracoscopic approach

Yang, Chenlu; Akar, Firas Abu; Chen, Jian; Jiang, Lei

doi:10.21037/jtd.2018.05.58

Cited by 5 publications

(8 citation statements)

References 8 publications

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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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“…Reports of number of cases, minimally invasive approach and complications are available in a few reports in the literature (summarized in Table 1) (29,(31)(32)(33)(35)(36)(37)(38). In more recent years the exponential growth experience in uniportal VATS have allowed for successful execution for these cases with good results (39,40).…”

Section: Minimally Invasive Approachmentioning

confidence: 99%

Tracheal and carinal resections in the treatment of non-small cell lung cancer: a trend to a minimally invasive approach

Guido-Guerrero¹,

Bolaños-Cubillo²,

García-Pérez³

et al. 2021

Curr Chall Thorac Surg

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Surgical treatment for non-small cell lung cancer (NSCLC) involving trachea and carina is one of the most infrequent and challenging procedures for a thoracic surgeon, requiring careful preoperative assessment, high level management of the airway, advanced surgical technique and appropriate postoperative care. Carinal and tracheal resections with lung sparing, and carinal sleeve pneumonectomy are part of these complex techniques, with a variable rate of morbidity and mortality. To prevent complications, the most important aspect of the technique is for reconstruction to be performed without tension and with a good blood supply. If a complication is suspected, it must be diagnosed at an early stage, and the problem must be handled aggressively to avoid further progression. The majority of cases are performed with an open approach, but under the care of surgeons and anesthesiologists experienced in minimally invasive thoracic procedures, with advanced airway management skills, in high volume referral centers, these procedures can be performed safely with video-assisted thoracic surgery to obtain good postoperative results. In recent years, with the rapid development of uniportal video assisted thoracic surgery (VATS), this approach resulted in shorter postoperative stays, less postoperative pain and faster recovery after surgery, maintaining oncological principles, becoming an excellent alternative for these difficult cases. This article aims to review the specific considerations that involve this kind of tumors, surgical technique and anesthesiology options, and the recent shift to a minimally invasive approach.

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“…Several publications came up to describe conducting complex operations by uniportal VATS technique through the intercostal and subxiphoid approaches (13)(14)(15)(16)(17). Surgeons all over the world began to adapt and expertise these techniques for a wide variety of operations (18)(19)(20)(21)(22)(23)(24). After gaining experience in uniportal VATS by intensive training in Shanghai Pulmonary Hospital "Ultra-high volume VATS center" and mastering the technique in different types of pulmonary procedures (25), We started by adapting the method to endemic diseases in our region as pulmonary Hydatid cyst.…”

Section: Introductionmentioning

confidence: 99%

Uniportal video assisted thoracoscopy versus open surgery for pulmonary hydatid disease—a single center experience

Akar¹,

González-Rivas²,

Shaqqura³

et al. 2020

J Thorac Dis

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Background: Although rare in the Western world, the incidence of hydatid disease is still prevalent and strikingly endemic among the Palestinians. Until 2017, surgical treatment of lung pathologies was performed through the traditional incision (open thoracotomy). Uniportal video-assisted thoracoscopic surgery (VATS) approach has recently been applied in the cases of the pulmonary hydatid cysts with very satisfactory results. Methods: Between January 2010 and January 2019, 39 patients with pulmonary HC disease have been surgically treated. The cases divided into two cohorts: operations performed by thoracotomy classified as group A, (n=16). Operations performed by uniportal VATS classified as group B, (n=23). Prospectively collected data was analysed retrospectively, and the results compared between both groups. Results: No significant statistical differences were noticed in terms of demographics and comorbidity.Laboratory tests were similar except haemoglobin level, which was higher in group A (P=0.001). Despite that, blood transfusion was higher in group A (P=0.016). Moreover, operation time was longer in group A (P=0.000). Chest drainage remained longer in group A (P=0.077). The level of postoperative pain was significantly higher in group A certainly in POD 1 (P=0.000). Patients in group B discharged earlier from the hospital (P=0.011) and experienced lower complications (P=0.060). No significant difference in length of ICU stay. Neither recurrence nor 30-day mortality recorded in either group. Conclusions: Uniportal VATS can be safely applied for pulmonary hydatidosis. It also seems to have a preference in several aspects compared to open Thoracotomy approach.

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Right sleeve pneumonectomy via uniportal video-assisted thoracoscopic approach

Abstract: Yang et al. Uniportal VATS right sleeve pneumonectomy Figure 4 Uniportal VATS right sleeve pneumonectomy and carinal reconstruction (9).

Cited by 5 publications

References 8 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

Tracheal and carinal resections in the treatment of non-small cell lung cancer: a trend to a minimally invasive approach

Uniportal video assisted thoracoscopy versus open surgery for pulmonary hydatid disease—a single center experience

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