Clinical analysis of uniportal video-assisted thoracoscopic double-sleeve lobectomy / 第二军医大学学报

ABSTRACT

ObjectiveTo explore the surgical technique and effectiveness of uniportal video-assisted thoracoscopic double-sleeve lobectomy and its clinical popularization value. MethodsThe clinical data of 19 consecutive patients (18 left-sided operations and 1 right-sided operation), who underwent uniportal video-assisted thoracoscopic double-sleeve lobectomy in Shanghai Pulmonary Hospital of Tongji University between Dec. 2016 and Jul. 2018, were included. Pre-, intra- and post-operative indicators were statistically analyzed, and the surgical patients were followed up. ResultsAmong 19 patients, there were 17 males and 2 females, with an average age of (62.3±6.6) years. The average operative time was (258.0±66.6) min, average operative blood loss was (210.0±157.8) mL, average bronchus anastomosis time was (26.0±5.8) min, average artery anastomosis time was (47.7±7.2) min, and average postoperative hospital stay was (7.6±4.5) d. Postoperative pathologic examination indicated that 15 cases had squamous cell carcinoma, 2 had adenocarcinoma, 1 had small cell carcinoma, and 1 had large cell carcinoma. TNM staging 11 cases was IIIa and 8 was IIIb. Four patients suffered postoperative complications, including 1 case of thrombosis at the vascular anastomosis, 1 arrhythmia and 2 prolonged airleak. There were no bronchial anastomotic fistula and anastomotic stenosis, vascular anastomosis stenosis or operative death. The average followup time was (16.4±6.4) months and no tumor recurrence or metastasis was found during follow-up after operation. ConclusionUniportal video-assisted thoracoscopic double-sleeve lobectomy is a technique-demanding operation, which can be carried out in the thoracic centers with endoscopy proficiency. It is feasible for completely removing tumor, preserving lung function to the greatest extent, and reducing surgical trauma to achieve rapid recovery of patients.