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Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy
BACKGROUND: Video-assisted thoracic surgery sleeve resection with bronchial anastomosis or bronchoplasty is a technically demanding procedure. Three-dimensional endoscopic surgery has been reported to be helpful in decreasing operation time and improving spatial perception with less surgical errors,...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520266/ https://www.ncbi.nlm.nih.gov/pubmed/34656152 http://dx.doi.org/10.1186/s13019-021-01685-7 |
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author | Seong, Yong Won Jeon, Jae Hyun Jang, Hyo-Jun Cho, Sukki Jheon, Sanghoon Kim, Kwhanmien |
author_facet | Seong, Yong Won Jeon, Jae Hyun Jang, Hyo-Jun Cho, Sukki Jheon, Sanghoon Kim, Kwhanmien |
author_sort | Seong, Yong Won |
collection | PubMed |
description | BACKGROUND: Video-assisted thoracic surgery sleeve resection with bronchial anastomosis or bronchoplasty is a technically demanding procedure. Three-dimensional endoscopic surgery has been reported to be helpful in decreasing operation time and improving spatial perception with less surgical errors, but there have been rare reports about relatively difficult thoracoscopic procedures utilizing 3D thoracoscope. We performed this study to evaluate early clinical outcomes of thoracoscopic sleeve resection and bronchoplasty utilizing 3D thoracoscope. METHODS: Data from a total of 36 patients who underwent thoracoscopic sleeve lobectomy or bronchoplasty at our institution from December 2015 to October 2017 were retrospectively reviewed. Three-port approach with one utility incision was used with a 10 mm, 30° three-dimensional thoracoscope. Twenty-three patients (81%) were male, and mean age was 65.9 ± 9.4 years. Fourteen patients (38.9%) underwent sleeve resection with bronchial anastomosis, 22 (61.1%) underwent wedge or simple bronchoplasty, and one patient received concomitant PA procedure. Bronchial anastomosis sites were not covered with viable tissue flaps. RESULTS: There was no (0%) suture needle injury from spatial misperception during bronchoplasty or sleeve anastomosis. There was no (0%) operative mortality. The pathologic report revealed squamous cell carcinoma (63.9%), adenocarcinoma (19.4%), carcinoid (6.9%), adenosquamous carcinoma (3.4%), and sarcomatoid carcinoma (2.8%). One (2.8%) late mortality was due to systemic recurrence of sarcomatoid carcinoma. There was no (0.0%) anastomotic failure. The mean number of dissected lymph nodes were 27.4 ± 13.2, and mean operation time was 216.8 ± 60.0 min. Median postoperative 24-h drain amount was 315 mL. Median chest tube days and hospital days were 4 and 6, respectively. Two patients (5.6%) had complications greater than Clavien-Dindo grade II—one case of ARDS, and the other case of a delayed bronchopleural fistula. CONCLUSIONS: Thoracoscopic sleeve resection and bronchoplasty utilizing HD 3D thoracoscope is a safe and effective procedure with excellent early clinical outcomes. Further investigation for long-term outcomes will be needed. |
format | Online Article Text |
id | pubmed-8520266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85202662021-10-20 Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy Seong, Yong Won Jeon, Jae Hyun Jang, Hyo-Jun Cho, Sukki Jheon, Sanghoon Kim, Kwhanmien J Cardiothorac Surg Research Article BACKGROUND: Video-assisted thoracic surgery sleeve resection with bronchial anastomosis or bronchoplasty is a technically demanding procedure. Three-dimensional endoscopic surgery has been reported to be helpful in decreasing operation time and improving spatial perception with less surgical errors, but there have been rare reports about relatively difficult thoracoscopic procedures utilizing 3D thoracoscope. We performed this study to evaluate early clinical outcomes of thoracoscopic sleeve resection and bronchoplasty utilizing 3D thoracoscope. METHODS: Data from a total of 36 patients who underwent thoracoscopic sleeve lobectomy or bronchoplasty at our institution from December 2015 to October 2017 were retrospectively reviewed. Three-port approach with one utility incision was used with a 10 mm, 30° three-dimensional thoracoscope. Twenty-three patients (81%) were male, and mean age was 65.9 ± 9.4 years. Fourteen patients (38.9%) underwent sleeve resection with bronchial anastomosis, 22 (61.1%) underwent wedge or simple bronchoplasty, and one patient received concomitant PA procedure. Bronchial anastomosis sites were not covered with viable tissue flaps. RESULTS: There was no (0%) suture needle injury from spatial misperception during bronchoplasty or sleeve anastomosis. There was no (0%) operative mortality. The pathologic report revealed squamous cell carcinoma (63.9%), adenocarcinoma (19.4%), carcinoid (6.9%), adenosquamous carcinoma (3.4%), and sarcomatoid carcinoma (2.8%). One (2.8%) late mortality was due to systemic recurrence of sarcomatoid carcinoma. There was no (0.0%) anastomotic failure. The mean number of dissected lymph nodes were 27.4 ± 13.2, and mean operation time was 216.8 ± 60.0 min. Median postoperative 24-h drain amount was 315 mL. Median chest tube days and hospital days were 4 and 6, respectively. Two patients (5.6%) had complications greater than Clavien-Dindo grade II—one case of ARDS, and the other case of a delayed bronchopleural fistula. CONCLUSIONS: Thoracoscopic sleeve resection and bronchoplasty utilizing HD 3D thoracoscope is a safe and effective procedure with excellent early clinical outcomes. Further investigation for long-term outcomes will be needed. BioMed Central 2021-10-16 /pmc/articles/PMC8520266/ /pubmed/34656152 http://dx.doi.org/10.1186/s13019-021-01685-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Seong, Yong Won Jeon, Jae Hyun Jang, Hyo-Jun Cho, Sukki Jheon, Sanghoon Kim, Kwhanmien Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy |
title | Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy |
title_full | Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy |
title_fullStr | Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy |
title_full_unstemmed | Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy |
title_short | Video-assisted thoracic surgery sleeve resection and bronchoplasty using 3D imaging system: its safety and efficacy |
title_sort | video-assisted thoracic surgery sleeve resection and bronchoplasty using 3d imaging system: its safety and efficacy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520266/ https://www.ncbi.nlm.nih.gov/pubmed/34656152 http://dx.doi.org/10.1186/s13019-021-01685-7 |
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