Video-assisted thoracoscopic lung cancer lobectomy for patients with incomplete interlobar fissure: is it a safe and reasonable procedure?

Hishida, Tomoyuki

doi:10.21037/jtd.2018.07.132

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…The risk of injury to visceral pleura during the interlobar approach of pulmonary arteries may result in prolonged postoperative air leaks that lead to prolonged hospital stay and delayed adjuvant treatment. 21 Thus, to know the presence of incomplete fissure before the operation may be very useful especially for surgeons with limited experience in minimally invasive surgery. This allows surgeons to plan an alternative strategy to conventional lobectomy as fissure-last approach to successfully handle incomplete fissure, prevent persistent postoperative air leaks, and contribute to reduce the conversion rate for incomplete interlobar fissure cases.…”

Section: Discussionmentioning

confidence: 99%

The Prediction of Fissure Integrity by Quantitative Computed Tomography Analysis

Noro

Natale

Messina

et al. 2022

Thorac Cardiovasc Surg

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Background Incomplete interlobar fissure may increase the difficulty of thoracoscopic lobectomy. Herein, we compared the accuracy of visual versus quantitative analysis to predict fissure integrity in lung cancer patients undergoing thoracoscopic lobectomy and evaluated the effects of fissure integrity on surgical outcome. Methods This was a single-center retrospective study including consecutive patients undergoing VATS (video-assisted thoracoscopic surgery) lobectomy for lung cancer. The target interlobar fissures were classified as complete or incomplete by visual and quantitative analysis. Using the intraoperative finding as the reference method, the diagnostic accuracy of the two methods to define fissure completeness (dependent variable) was calculated and statistically compared. Yet, we evaluated differences in postoperative outcomes between patients with complete and incomplete fissure integrity. Results A total of 93 patients were included in the study; 33/93 (36%) presented complete fissure. Visual and quantitative analyses correctly identified complete fissure in 19/33 (57%) and 29/33 (88%) patients, respectively, and incomplete fissure in 56/60 (93%) and 58/60 (96%) patients, respectively. Quantitative analysis had better diagnostic accuracy than visual analysis (81 vs. 93%; p = 0.01). Patients with incomplete fissure compared with those with complete fissure had a higher conversion rate (6 vs. 13%; p = 0.43), higher persistent air leak rate (0/33 vs. 14/60; p = 0.03), and longer hospitalization (12.6 ± 3.8 vs. 7.1 ± 2.4 days; p = 0.01). Conclusions Quantitative analysis accurately predicted the fissures' integrity; it may be useful for selecting suitable cases for thoracoscopic lobectomy especially for surgeons with limited minimally invasive experience.

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Section: Discussionmentioning

confidence: 99%

The Prediction of Fissure Integrity by Quantitative Computed Tomography Analysis

Noro

Natale

Messina

et al. 2022

Thorac Cardiovasc Surg

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“…The thoughtful editorial conducted by Dr. Hishida raises three important questions regarding to our study that merit in-depth consideration (1).…”

Section: (Ii)mentioning

confidence: 99%

“…We would like to appreciate Dr. Hishida (1), Dr. Lococo with his colleagues (2) and Dr. Lee with his colleagues (3) for their interests and positive comments regarding to our recent single-center retrospective study addressing on the significance of degree of pulmonary fissure completeness (PFC) in video-assisted thoracoscopic surgery (VATS) lobectomy for non-small-cell lung cancer (NSCLC) (4). Meanwhile, we would also like to thank Dr. Laura Chiara Guglielmetti, the Section Editor of the Journal of Thoracic Disease, for her commission to invite the three professionals in the specialty of thoracic surgery to contribute their great editorials on our work.…”

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confidence: 99%

Authors’ response: it’s time to consider integrating the degree of pulmonary fissure completeness into a morbidity risk scoring system for video-assisted thoracoscopic pulmonary resections

Che

2018

J. Thorac. Dis

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Initial Airtightness of the Lung Parenchyma After Transection of the Interlobar Fissure – Monopolar Cutter, Stapler Versus Nd: YAG Laser

Kirschbaum

Eigendorf

Wiesmann

et al. 2022

Journal of Surgical Research

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Video-assisted thoracoscopic lung cancer lobectomy for patients with incomplete interlobar fissure: is it a safe and reasonable procedure?

Abstract: et al. Effects of degree of pulmonary fissure completeness on major in-hospital outcomes after video-assisted thoracoscopic lung cancer lobectomy: a retrospective-cohort study.

Cited by 3 publications

References 3 publications

The Prediction of Fissure Integrity by Quantitative Computed Tomography Analysis

The Prediction of Fissure Integrity by Quantitative Computed Tomography Analysis

Authors’ response: it’s time to consider integrating the degree of pulmonary fissure completeness into a morbidity risk scoring system for video-assisted thoracoscopic pulmonary resections

Initial Airtightness of the Lung Parenchyma After Transection of the Interlobar Fissure – Monopolar Cutter, Stapler Versus Nd: YAG Laser

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