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Thorac Cardiovasc Surg 2019; 67(02): 137-141
DOI: 10.1055/s-0038-1642618
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

The Feasibility of Thoracoscopic Left Pneumonectomy

Hao Xu
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
,
Linyou Zhang
1   Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
› Author Affiliations
Further Information

Publication History

23 October 2017

13 March 2018

Publication Date:
01 May 2018 (online)

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Abstract

Objective In this study, we describe our experience with video-assisted thoracoscopic surgery (VATS) left pneumonectomy as a treatment for advanced malignant and benign diseases.

Methods Patients who underwent VATS left pneumonectomy in our clinic between October 2013 and August 2017 were retrospectively evaluated. VATS pneumonectomy was successfully completed in 46 patients. We reviewed and analyzed the characteristics of the patients in addition to intraoperative parameters, chest tube duration, length of hospital stay, morbidity, and mortality.

Results A total of 46 patients underwent VATS left pneumonectomy. Of these, 43 patients had malignant tumors and 3 patients had destroyed lung. The histologic types were squamous cell carcinoma in 24 patients, adenocarcinoma in 11, large cell carcinoma in 2, sarcomatoid carcinoma in 1, follicular dendritic cell sarcoma in 1, and small cell carcinoma in 4. Primary lung cancers were classified as stage IA1 in 2 patients, IA2 in 2, IA3 in 1, IB in 3, IIA in 3, IIB in 11, IIIA in 18, and IIIB in 3. The mean operation time was 160.54 ± 43.44 minutes, and the mean blood loss was 401.09 ± 284.32 mL. There was no perioperative mortality and no secretion retention and bronchopleural fistula. Arrhythmia was found in three patients. Pneumonia was found in four patients. The median follow-up time in this cohort was 25 months. A total of 15 patients (34.8%) developed recurrent diseases, 12 developed distant or multiple metastasis, and 3 developed locoregional recurrence.

Conclusion VATS pneumonectomy is a safe, feasible treatment for complicated diseases that induces acceptable damage and has lower morbidity.

Keywords

thoracoscopy/VATS - lung cancer - treatment - medical - surgery - complications
 

  • References

  • 1 Fell SC. A history of pneumonectomy. Chest Surg Clin N Am 1999; 9 (02) 267-290 , ix
    PubMedGoogle Scholar
  • 2 Jungraithmayr W, Hasse J, Olschewski M, Stoelben E. Indications and results of completion pneumonectomy. Eur J Cardiothorac Surg 2004; 26 (01) 189-196
    CrossrefPubMedGoogle Scholar
  • 3 Owen RM, Force SD, Pickens A, Mansour KA, Miller DL, Fernandez FG. Pneumonectomy for benign disease: analysis of the early and late outcomes. Eur J Cardiothorac Surg 2013; 43 (02) 312-317
    CrossrefPubMedGoogle Scholar
  • 4 Thomas PA, Berbis J, Baste JM. , et al; EPITHOR group. Pneumonectomy for lung cancer: contemporary national early morbidity and mortality outcomes. J Thorac Cardiovasc Surg 2015; 149 (01) 73-82
    CrossrefPubMedGoogle Scholar
  • 5 Pagès PB, Mordant P, Renaud S. , et al. Sleeve lobectomy may provide better outcomes than pneumonectomy for non-small cell lung cancer. A decade in a nationwide study. J Thorac Cardiovasc Surg 2017; 153 (01) 184-195
    CrossrefPubMedGoogle Scholar
  • 6 Paul S, Altorki NK, Sheng S. , et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg 2010; 139 (02) 366-378
    CrossrefPubMedGoogle Scholar
  • 7 Swanson SJ, Meyers BF, Gunnarsson CL. , et al. Video-assisted thoracoscopic lobectomy is less costly and morbid than open lobectomy: a retrospective multiinstitutional database analysis. Ann Thorac Surg 2012; 93 (04) 1027-1032
    CrossrefPubMedGoogle Scholar
  • 8 Walker WS, Carnochan FM, Mattar S. Video-assisted thoracoscopic pneumonectomy. Br J Surg 1994; 81 (01) 81-82
    CrossrefPubMedGoogle Scholar
  • 9 Liu Y, Gao Y, Zhang H. , et al. Video-assisted versus conventional thoracotomy pneumonectomy: a comparison of perioperative outcomes and short-term measures of convalescence. J Thorac Dis 2016; 8 (12) 3537-3542
    CrossrefPubMedGoogle Scholar
  • 10 Sahai RK, Nwogu CE, Yendamuri S, Tan W, Wilding GE, Demmy TL. Is thoracoscopic pneumonectomy safe?. Ann Thorac Surg 2009; 88 (04) 1086-1092
    CrossrefPubMedGoogle Scholar
  • 11 Nwogu CE, Yendamuri S, Demmy TL. Does thoracoscopic pneumonectomy for lung cancer affect survival?. Ann Thorac Surg 2010; 89 (06) S2102-S2106
    CrossrefPubMedGoogle Scholar
  • 12 Miller DL, Deschamps C, Jenkins GD, Bernard A, Allen MS, Pairolero PC. Completion pneumonectomy: factors affecting operative mortality and cardiopulmonary morbidity. Ann Thorac Surg 2002; 74 (03) 876-883 , discussion 883–884
    CrossrefPubMedGoogle Scholar
  • 13 Muysoms FE, de la Rivière AB, Defauw JJ. , et al. Completion pneumonectomy: analysis of operative mortality and survival. Ann Thorac Surg 1998; 66 (04) 1165-1169
    CrossrefPubMedGoogle Scholar
  • 14 Kim HS, , i H, Choi YS, Kim K, Shim YM, Kim J. Surgical resection of recurrent lung cancer in patients following curative resection. J Korean Med Sci 2006; 21 (02) 224-228
    CrossrefPubMedGoogle Scholar
  • 15 Cardillo G, Galetta D, van Schil P. , et al. Completion pneumonectomy: a multicentre international study on 165 patients. Eur J Cardiothorac Surg 2012; 42 (03) 405-409
    CrossrefPubMedGoogle Scholar
  • 16 The Society for Cardiothoracic Surgery in Great Britain and Ireland. Second National Thoracic Surgery Activity and Outcomes Report 2011. Available at: http://www.scts.org/_userfiles/resources/634558869917493937_Thoracic_2011_FINAL.pdf . Accessed March 9, 2014
    PubMedGoogle Scholar
  • 17 Perrot E, Guibert B, Mulsant P. , et al. Preoperative chemotherapy does not increase complications after non-small cell lung cancer resection. Ann Thorac Surg 2005; 80 (02) 423-427
    CrossrefPubMedGoogle Scholar
  • 18 Shapiro M, Swanson SJ, Wright CD. , et al. Predictors of major morbidity and mortality after pneumonectomy utilizing the Society for Thoracic Surgeons General Thoracic Surgery Database. Ann Thorac Surg 2010; 90 (03) 927-934 , discussion 934–935
    CrossrefPubMedGoogle Scholar
  • 19 Darling GE, Abdurahman A, Yi QL. , et al. Risk of a right pneumonectomy: role of bronchopleural fistula. Ann Thorac Surg 2005; 79 (02) 433-437
    CrossrefPubMedGoogle Scholar
  • 20 Bernard A, Deschamps C, Allen MS. , et al. Pneumonectomy for malignant disease: factors affecting early morbidity and mortality. J Thorac Cardiovasc Surg 2001; 121 (06) 1076-1082
    CrossrefPubMedGoogle Scholar
  • 21 Martin J, Ginsberg RJ, Abolhoda A. , et al. Morbidity and mortality after neoadjuvant therapy for lung cancer: the risks of right pneumonectomy. Ann Thorac Surg 2001; 72 (04) 1149-1154
    CrossrefPubMedGoogle Scholar
  • 22 Mansour Z, Kochetkova EA, Santelmo N. , et al. Risk factors for early mortality and morbidity after pneumonectomy: a reappraisal. Ann Thorac Surg 2009; 88 (06) 1737-1743
    CrossrefPubMedGoogle Scholar
  • 23 Hartwig MG, D'Amico TA. Thoracoscopic lobectomy: the gold standard for early-stage lung cancer?. Ann Thorac Surg 2010; 89 (06) S2098-S2101
    CrossrefPubMedGoogle Scholar
  • 24 Naidoo R, Windsor MN, Goldstraw P. Surgery in 2013 and beyond. J Thorac Dis 2013; 5 (Suppl. 05) S593-S606
    PubMedGoogle Scholar
  • 25 Villamizar NR, Darrabie MD, Burfeind WR. , et al. Thoracoscopic lobectomy is associated with lower morbidity compared with thoracotomy. J Thorac Cardiovasc Surg 2009; 138 (02) 419-425
    CrossrefPubMedGoogle Scholar
  • 26 Conlan AA, Sandor A. Total thoracoscopic pneumonectomy: indications and technical considerations. J Thorac Cardiovasc Surg 2003; 126 (06) 2083-2085
    CrossrefPubMedGoogle Scholar
  • 27 Craig SR, Walker WS. Initial experience of video assisted thoracoscopic pneumonectomy. Thorax 1995; 50 (04) 392-395
    CrossrefPubMedGoogle Scholar
  • 28 Licker M, de Perrot M, Höhn L. , et al. Perioperative mortality and major cardio-pulmonary complications after lung surgery for non-small cell carcinoma. Eur J Cardiothorac Surg 1999; 15 (03) 314-319
    CrossrefPubMedGoogle Scholar
  • 29 Schneider L, Farrokhyar F, Schieman C. , et al. Pneumonectomy: the burden of death after discharge and predictors of surgical mortality. Ann Thorac Surg 2014; 98 (06) 1976-1981 , discussion 1981–1982
    CrossrefPubMedGoogle Scholar
  • 30 Romano PS, Mark DH. Patient and hospital characteristics related to in-hospital mortality after lung cancer resection. Chest 1992; 101 (05) 1332-1337
    CrossrefPubMedGoogle Scholar
  • 31 Ferguson MK. Assessment of operative risk for pneumonectomy. Chest Surg Clin N Am 1999; 9 (02) 339-351
    PubMedGoogle Scholar
  • 32 Licker M, Spiliopoulos A, Frey JG. , et al. Risk factors for early mortality and major complications following pneumonectomy for non-small cell carcinoma of the lung. Chest 2002; 121 (06) 1890-1897
    CrossrefPubMedGoogle Scholar
  • 33 Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg 1992; 54 (01) 84-88
    CrossrefPubMedGoogle Scholar