Triportal Video- Assisted Thoracoscopic Vats Lobectomy Can Be Performed Safely In Patients With Malignant Lung Cancer: Results of a Single-Centre
Abstract
Purpose: Our objective was to analyze the results of the patients with malignant lung tumor who underwent triportal VATS lung resection in our clinic in the 2010–2018 period. Patients and methods: Between August 2010 and January 2018, 46 patients with malignant tumors 37 male, 9 female underwent triportal VATS lobectomy. Mean age of the patients was 55.5 age range: 16-78 . Patients’ pre-operation features additional diseases, comorbidities , amount of bleeding, operation duration, resection type, number of sampled lymph nodes, postoperative conditions amount of drainage, duration of drainage, hospital stay , complications and postoperative pain scores were recorded. Results: The pathological diagnosis was adenocarcinoma in 29 patients, squamous cell carcinoma in 10 patients and other tumor types in 7 patients. 21 patients had preoperative comorbidities. The conversion rate was 4.3%. No operative mortality was observed. The average operation time was calculated as 169 minutes range 75-285 minutes , while the average duration of hospital stay was 5.1 days and the average duration of drainage was 4.2 days. Perioperative and postoperative drainage was 219 mL and 679 mL respectively. Complication rate was 15.2 percent pneumonia; 6.5%, extended air leakage; 2.1%, arrhythmia; 4.3% and subcutaneous emphysema; 2.1% . The visual analogue pain scale value was 2.8 percent on the first post-operative day. Regarding the harvested lymph node samples, the average number of harvested lymph nodes was 17. Conclusion: VATS lobectomy is a successful and reliable technique in patients with malignant lung cancer due to its low morbidity rates as well as satisfactory postoperative results.
References
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5–29. [CrossRef]
- Howington JA, Blum MG, Chang AC, Balekian AA, Murthy SC. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143:e278S–313S. [CrossRef]
- Yan TD, Black D, Bannon PG, McCaughan BC. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early- stage nonsmall- cell lung cancer. J Clin Oncol 2009;27:2553–62. [CrossRef]
- Cao C, Chandrakumar D, Gupta S, Yan TD, Tian DH. Could less be more?-A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer 2015;89:121–32. [CrossRef]
- Ismail M, Helmig M, Swierzy M, Neudecker J, Badakhshi H, Gonzalez- Rivas D, Rückert JC. Uniportal VATS. the first German experience. J Thorac Dis 2014;6:S650–5. [CrossRef]
- Sakuraba M, Miyamoto H, Oh S, Shiomi K, Sonobe S, Takahashi N, et al. Video-assisted thoracoscopic lobectomy vs. conventional lobectomy via open thoracotomy in patients with clinical stage IA nonsmall cell lung carcinoma. Interact Cardiovasc Thorac Surg 2007;6:614–7. [CrossRef]
- Sawada S, Komori E, Yamashita M, Nakata M, Nishimura R, Teramoto N, et al. Comparison in prognosis after VATS lobectomy and open lobectomy for stage I lung cancer: retrospective analysis focused on a histological subgroup. Surg Endosc 2007;21:1607–11. [CrossRef]
- of lymph nodes in the radiologically normal mediastinum. Eur Resp
- J 2006;28:910–4. [CrossRef]
- Burfeind WR, D’Amico TA. Thoracoscopic lobectomy. Oper Tec Thorac Cardiovasc Surg 2004;9:98–114. Erişim: https://www.optechtcs. com/article/S1522-2942(04)00030-3/pdf
- Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 2008;86:2008–18. [CrossRef]
- Sakuraba M, Miyamoto H, Oh S, Shiomi K, Sonobe S, Takahashi N. Video-assisted thoracoscopic lobectomy vs. conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small cell lung carcinoma. Interact Cardiovasc Thorac Surg 2007;6:614–7. [CrossRef]
- Demmy TL, Curtis JJ. Minimally invasive lobectomy directed toward frail and high-risk patients: a case-control study. Ann Thorac Surg 1999;68:194–200. [CrossRef]
- Belgers EHJ, Siebenga J, Bosch AM, van Haren EHJ, Bollen ECM. Complete video-assisted thoracoscopic surgery lobectomy and its learning curve. A single center study introducing the technique in The Netherlands. Interact Cardiovasc Thorac Surg 2010;10:176–80. [CrossRef]
- Harris CG, James RS, Tian DH, Yan TD, Doyle MP, Gonzalez-Rivas D, Cao C. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg 2016;5:76–84. [CrossRef]
Malign Akciğer Kanserli Hastalarda Üç-Port Video-Yardımlı Torakoskopik Cerrahi VATS ile Lobektomi Güvenle Uygulanabilir: Tek Merkezli Çalışma Sonuçları
Abstract
Amaç: Bu çalışmada kliniğimizde 2010–2018 yılları arasında üç port VATS tekniği ile akciğer rezeksiyonu uygulanan malign akciğer tümörlü hastalarımızın sonuçlarını irdelemeyi amaçladık. Hastalar ve yöntemler: Ağustos 2010–Ocak 2018 tarihleri arasında toplam 46 hastaya Erkek:37 hasta, Kadın:9 hasta malign nedenler ile üç port VATS lobektomi uygulandı. Ortalama yaş 55.5 olarak saptandı 16–78 yaş arası . Hastaların ameliyat öncesi özellikleri ek hastalık, komorbiditeler , kanama miktarı, ameliyat süreleri, yapılan rezeksiyon tipi, örneklenen lenf nodu sayıları, postoperatif takip özellikleri drenaj miktarı, drenaj süresi, hastanede kalış süresi , komplikasyonları, postoperatif ağrı skorları retrospektif olarak değerlendirildi. Bulgular: Hastaların patolojik tanısı 29 hastada adenokarsinom, 10 hastada skuamöz hücreli karsinom ve 7 hastada diğer tümör tipleri olarak saptandı. Hastaların 21 tanesinde preoperatif komorbiditeler mevcuttu. Açığa dönme oranı %4.3 olarak saptandı. Operatif mortalite görülmedi. Ortalama operasyon süresi 169 dakika 75–285 dk. , hastanede kalış süresi ortalama 5.1 gün, ortalama dren kalış süresi 4.2 gün olarak hesaplandı. Peroperatif ve postoperatif drenaj miktarları sırası ile 219 ml ve 679 ml olarak ortaya konuldu. Komplikasyon oranı %15.2 olarak saptandı pnömoni 3 hasta %6.5, Uzamış hava kaçağı 1 hasta %2.1, aritmi 2 hasta %4.3 ve cilt altı amfizem 1 hasta %2.1 . Ameliyat sonrası 1.gün görsel analog ağrı skalası değeri ise 2.8 değerindeydi. Ortalama çıkartılan lenf nodu örnekleri göz önüne alındığında ortalama çıkartılan lenf nodu sayısı 17 olarak saptandı. Sonuç: Malign akciğer kanserli hastalarda VATS lobektomi başarıyla ve düşük morbidite ve tatmin edici postoperatif sonuçları ile güvenle tercih edilebilecek bir tekniktir.
Keywords
References
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5–29. [CrossRef]
- Howington JA, Blum MG, Chang AC, Balekian AA, Murthy SC. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013;143:e278S–313S. [CrossRef]
- Yan TD, Black D, Bannon PG, McCaughan BC. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early- stage nonsmall- cell lung cancer. J Clin Oncol 2009;27:2553–62. [CrossRef]
- Cao C, Chandrakumar D, Gupta S, Yan TD, Tian DH. Could less be more?-A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer 2015;89:121–32. [CrossRef]
- Ismail M, Helmig M, Swierzy M, Neudecker J, Badakhshi H, Gonzalez- Rivas D, Rückert JC. Uniportal VATS. the first German experience. J Thorac Dis 2014;6:S650–5. [CrossRef]
- Sakuraba M, Miyamoto H, Oh S, Shiomi K, Sonobe S, Takahashi N, et al. Video-assisted thoracoscopic lobectomy vs. conventional lobectomy via open thoracotomy in patients with clinical stage IA nonsmall cell lung carcinoma. Interact Cardiovasc Thorac Surg 2007;6:614–7. [CrossRef]
- Sawada S, Komori E, Yamashita M, Nakata M, Nishimura R, Teramoto N, et al. Comparison in prognosis after VATS lobectomy and open lobectomy for stage I lung cancer: retrospective analysis focused on a histological subgroup. Surg Endosc 2007;21:1607–11. [CrossRef]
- of lymph nodes in the radiologically normal mediastinum. Eur Resp
- J 2006;28:910–4. [CrossRef]
- Burfeind WR, D’Amico TA. Thoracoscopic lobectomy. Oper Tec Thorac Cardiovasc Surg 2004;9:98–114. Erişim: https://www.optechtcs. com/article/S1522-2942(04)00030-3/pdf
- Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 2008;86:2008–18. [CrossRef]
- Sakuraba M, Miyamoto H, Oh S, Shiomi K, Sonobe S, Takahashi N. Video-assisted thoracoscopic lobectomy vs. conventional lobectomy via open thoracotomy in patients with clinical stage IA non-small cell lung carcinoma. Interact Cardiovasc Thorac Surg 2007;6:614–7. [CrossRef]
- Demmy TL, Curtis JJ. Minimally invasive lobectomy directed toward frail and high-risk patients: a case-control study. Ann Thorac Surg 1999;68:194–200. [CrossRef]
- Belgers EHJ, Siebenga J, Bosch AM, van Haren EHJ, Bollen ECM. Complete video-assisted thoracoscopic surgery lobectomy and its learning curve. A single center study introducing the technique in The Netherlands. Interact Cardiovasc Thorac Surg 2010;10:176–80. [CrossRef]
- Harris CG, James RS, Tian DH, Yan TD, Doyle MP, Gonzalez-Rivas D, Cao C. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg 2016;5:76–84. [CrossRef]
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 1, 2019 |
| Published in Issue | Year 2019Issue: 4 |