Shengcheng Lin1, Chenglin Yang1, Xiaotong Guo1, Yafei Xu2, Lixu Wang1, Zhe Wang1, Xin Yu1, Chunguang Wang1, Zhentao Yu3. 1. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China. 2. Department of Anesthesiology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, China. 3. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China. yuzhentao@chcamssz.ac.cn.
Abstract
BACKGROUND: Surgical resection is an appropriate treatment option for synchronous bilateral pulmonary nodules with ground-glass opacities. The applicability of simultaneous uniportal video-assisted thoracic surgery is not fully understood. We evaluated the feasibility and safety of performing such surgeries at our hospital. METHODS: Clinical data of 35 patients who underwent simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery at our hospital were reviewed retrospectively. RESULTS: Simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery was performed for 35 patients (15 men, 20 women); 97 nodules were operated on, and the average nodule diameter was 11.4 mm (range, 1-38 mm). Computerized tomography showed that most nodules had ground-glass opacity (52/97, 53.6%); solid nodules (24/97, 24.7%) and nodules with mixed ground-glass opacity (21/97, 21.7%) were noted. Surgical resection included lobar-sublobar resection (11/35, 31.4%) and sublobar-sublobar resection (24/35, 68.6%). Wound infection and postoperative 30-day mortality were not observed. Pneumonia was the major postoperative complication, with a higher incidence in the lobar-sublobar group (6/10, 60%) than in the sublobar-sublobar group (4/25, 16%; P = 0.016). Pneumonia did not correlate with operative time (mean, 262.3 ± 108.1 vs. 261.9 ± 87.5 min, P = 0.991), duration of chest drainage (mean, 7.0 ± 4.0 vs 5.4 ± 2.1 days, P = 0.124), and postoperative hospital stay (mean, 10.2 ± 3.6 vs 10.2 ± 6.4 days, P = 0.978). The mean follow-up time was 8 (range, 3-22) months. Recurrence of primary lung cancer or mortality was not noted at the final follow-up. CONCLUSIONS: Simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery is feasible and safe for appropriate patients. Simultaneous lobar-sublobar pulmonary resection for bilateral nodules can increase the risk of developing pneumonia.
BACKGROUND: Surgical resection is an appropriate treatment option for synchronous bilateral pulmonary nodules with ground-glass opacities. The applicability of simultaneous uniportal video-assisted thoracic surgery is not fully understood. We evaluated the feasibility and safety of performing such surgeries at our hospital. METHODS: Clinical data of 35 patients who underwent simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery at our hospital were reviewed retrospectively. RESULTS: Simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery was performed for 35 patients (15 men, 20 women); 97 nodules were operated on, and the average nodule diameter was 11.4 mm (range, 1-38 mm). Computerized tomography showed that most nodules had ground-glass opacity (52/97, 53.6%); solid nodules (24/97, 24.7%) and nodules with mixed ground-glass opacity (21/97, 21.7%) were noted. Surgical resection included lobar-sublobar resection (11/35, 31.4%) and sublobar-sublobar resection (24/35, 68.6%). Wound infection and postoperative 30-day mortality were not observed. Pneumonia was the major postoperative complication, with a higher incidence in the lobar-sublobar group (6/10, 60%) than in the sublobar-sublobar group (4/25, 16%; P = 0.016). Pneumonia did not correlate with operative time (mean, 262.3 ± 108.1 vs. 261.9 ± 87.5 min, P = 0.991), duration of chest drainage (mean, 7.0 ± 4.0 vs 5.4 ± 2.1 days, P = 0.124), and postoperative hospital stay (mean, 10.2 ± 3.6 vs 10.2 ± 6.4 days, P = 0.978). The mean follow-up time was 8 (range, 3-22) months. Recurrence of primary lung cancer or mortality was not noted at the final follow-up. CONCLUSIONS: Simultaneous bilateral pulmonary resection with uniportal video-assisted thoracic surgery is feasible and safe for appropriate patients. Simultaneous lobar-sublobar pulmonary resection for bilateral nodules can increase the risk of developing pneumonia.
Authors: Asad A Shah; Michael E Barfield; Chris R Kelsey; Mark W Onaitis; Betty Tong; David Harpole; Thomas A D'Amico; Mark F Berry Journal: Ann Thorac Surg Date: 2012-03-03 Impact factor: 4.330
Authors: Nasser K Altorki; Rowena Yip; Takaomi Hanaoka; Thomas Bauer; Ralph Aye; Leslie Kohman; Barry Sheppard; Richard Thurer; Shahriyour Andaz; Michael Smith; William Mayfield; Fred Grannis; Robert Korst; Harvey Pass; Michaela Straznicka; Raja Flores; Claudia I Henschke Journal: J Thorac Cardiovasc Surg Date: 2013-11-23 Impact factor: 5.209