ABSTRACT
PURPOSE: Due to the improvement of thoracoscopic thchnology and surgeon’s ability, plenty of nonsmall cell lung cancer (NSCLC) was treated by video‑assisted thoracic surgery (VATS). This study was designed to evaluate the quality of life (QOL) and survival in II stage NSCLC patients following lobectomy, comparing VATS with thoracotomy. METHODS: Between 2010 and 2012, 217 II stage NSCLC patients (VATS: 114 patients, OPEN: 103 patients) were enrolled in a long‑standing, prospective observational lung cancer surgery outcomes study. Short‑form 36 health survey (SF‑36) and time to progression (TTP) were measured to evaluate the QOL and postoperative survival. RESULTS: There were significant differences between the two groups in the preoperative radiation therapy and differentiation, and the VATS group had less postoperative complication, blood loss, intraoperative fluid administration, and shorter length of stay. Statistical analysis of SF‑36 questionnaire revealed that VATS group score was higher on seven health dimensions: Bodily pain (BP), energy (EG), general health, physical functioning, mental health, SF, and role‑physical (RP), but only BP, EG, and RP have statistical significance. Using survival analysis, there was no significant difference between VATS and OPEN group, in which the mean TTP of VATS group is 18.5 months, while OPEN group is 20 months. CONCLUSIONS: VATS lobectomy tends to score higher on the QOL and functioning scales and has equivalent postsurgical survival compared with OPEN lobectomy for II stage nonsmall cell carcinoma patients.
ABSTRACT
BACKGROUND: Nonsmall cell lung cancer is the leading cause of cancer mortality worldwide because of distant metastasis and frequent recurrence. Only few reliable and easily accessible tumor markers have been clinically implemented to the early nonsmall cell cancer prognosis. OBJECTIVE: The purpose of this study is to detect the expression of CUG‑binding protein (CUGBP1) and assess the prognostic significance of CUGBP1 in early stage (IB) lung adenocarcinoma patients. MATERIALS AND METHODS: Using quantitative reverse transcription‑polymerase chain reaction (PCR) and immunohistochemistry (IHC) analysis, we detect the expression of CUGBP1 and assess their correlation with clinicopathological parameters by Chi‑square test. Time to progression (TTP) was used as a recurrent index and was evaluated by univariate and multivariate analysis in the Cox hazard model. RESULTS: Using PCR and IHC analyses, the expression of CUGBP1 and CUGBP1 messenger RNA (mRNA) had a close relationship with differentiation and vascular–invasion (VI). However, there were no significant differences between the CUGBP1 mRNA expression and CUGBP1 protein expression in IB lung adenocarcinoma. Using univariate and multivariate survival analyses, we found that CUGBP1 and VI were independent prognostic factors for IB stage adenocarcinoma individuals postsurgically. CONCLUSIONS: High expression of CUGBP1 could enhance the recurrence rate of adenocarcinoma and predicts an adverse postsurgical survival of TTP. Combination of CUGBP1 and VI detecting could be considered as indication to predict prognosis of IB stage adenocarcinoma in the clinical trial.
ABSTRACT
For thoracoscopic upper lobectomies, most cutting endostaplers must be inserted through the camera port when using a two-port approach. Access to the hilar vasculature through only the utility port remains a challenge. In this study, we describe a procedure to access the hilar vasculature without transferring the endostapler site during a thoracoscopic right upper lobectomy. A 2.5-cm utility anterior incision was made in the fourth intercostal space. The posterior mediastinal visceral pleura were dissected to expose the posterior portion of the right upper bronchus and the anterior trunk of the right pulmonary artery. The pleura over the right hilar vasculature were then peeled with an electrocoagulation hook. The anterior trunk of the right pulmonary artery was then transected with a cutting endostapler through the utility port firstly. This crucial maneuver allowed the endostapler access to the right upper lobe pulmonary vein. The hilar structures were then easily handled in turn. This novel technique was performed successfully in 32 patients, with no perioperative deaths. The average operation time was 120.6 min (range 75–180 min). This novel technique permits effective control of the hilar vessels through the utility port, enabling simple, safe, quick and effective resection.
Subject(s)
Humans , Lung Neoplasms/surgery , Pneumonectomy/methods , Surgical Staplers/therapeutic use , Thoracoscopy/methods , Thoracic Surgical Procedures/methodsABSTRACT
BACKGROUND: We review our experiences with video‑assisted thoracoscopic surgery (VATS) sleeve lobectomy with bronchoplasty for nonsmall‑cell lung cancer, using only two incisions. The aim of this study was to evaluate the technical feasibility and safety of surgical approach. MATERIALS AND METHODS: From January 2013 to January 2014, we completed 15 cases of VATS sleeve lobectomy with bronchoplasty in our hospital. The patients underwent sleeve lobectomy with bronchoplasty at the following locations: right upper lobe (n = 4), right lower and middle lobes (n = 1), left lower lobe (n = 5), and left upper lobe (n = 6). The operation consisted of VATS anatomic sleeve lobectomy with bronchoplasty combined with systematic lymph node dissection, using only two incisions. RESULTS: The patients underwent sleeve lobectomy with bronchoplasty were no postoperative complications. Median operative time was 183 min; median bronchial anastomosis time was 39 min; median blood loss was 170 ml. Pathological examination showed 12 squamous cell carcinomas and 3 adenocarcinoma. Median postoperative chest tube drainage duration was 4.5 days, and median hospital stay was 6.9 days. CONCLUSIONS: Video‑assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty is a feasible and safe surgical approach, using only two incisions. This way of operation can promote the development of surgical technology.