Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIANG Lianyong , XIE Xiao , HU Fengqing , WANG Lei , HU Rui ,  XIAO Haibo , WANG Mingsong , LI Guoqing , MEI Ju

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200092, P.R.China;

Corresponding author：

XIAO Haibo, Email: xiaohaibo@xinhuamed.com.cn

Keywords：

Multiple nodules; bilateral; single-stage; video-assisted thoracic surgery (VATS)

DOI：

10.7507/1007-4848.201710039

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To share the experience of single-stage bilateral pulmonary resections by video-assisted thoracic surgery (VATS) for multiple nodules. Methods Clinical records of patients undergoing one-stage bilateral resections of multiple pulmonary nodules between January 2015 and December 2016 in our institution were retrospectively reviewed and analyzed. There were 9 males and 15 females, aged from 33 to 69 (55.0±8.0) years. Two patients underwent bilateral lobectomy. Lobar-sublobar (L/SL) resection and bilateral sublobar resection (SL-SL) were conducted in 9 patients and 13 patients respectively. Results All operations completed successfully. Operation time was 135–330 (231.4±59.1) min, duration of use of chest drains was 2–17 (5.4±3.1) days. Overall duration of hospitalization after surgery was 5–37 (8.6±6.3) days. There was no perioperative death. Postoperative course was uneventful in 17 (70.8%) patients. The postoperative complications included one patient of incision infection and one patient of pulmonary infection. Persistent air leak for >3 days duration and unilateral pleural drainage for more than 200 ml/d were observed in 3 patients and 2 patients respectively. Conclusion Single-stage bilateral surgery in selected patients with synchronous bilateral multiple nodules is feasible and associated with satisfactory outcomes.

Citation： JIANG Lianyong, XIE Xiao, HU Fengqing, WANG Lei, HU Rui, XIAO Haibo, WANG Mingsong, LI Guoqing, MEI Ju. Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(9): 750-754. doi: 10.7507/1007-4848.201710039 Copy

1.	Nakata M, Sawada S, Yamashita M, et al. Surgical treat-ments for multiple primary lung adenocarcinoma of the lung. Ann Thorac Surg, 2004, 78(4): 1194-1199.
2.	Matsuge S, Hosokawa Y, Satoh K, et al. Surgical treatment for bilateral multiple lung cancers. Kyobu Geka, 2000, 53(2): 89-94.
3.	Iino K, Oda M, Tsunezuka Y, et al. Treatment for bilateral multiple lung cancers. Kyobu Geka, 2002, 55(6): 443-448.
4.	Ambrosini V, Nicolini S, Caroli P, et al. PET/CT imaging in different types of lung cancer: an overview. Eur J Radiol, 2012, 81(5): 988-1001.
5.	Lee HY, Lee KS. Ground-glass opacity nodules: histopathology, imaging evaluation, and clinical implications. J Thorac Imaging, 2011, 26(2): 106-118.
6.	Huang TW, Lin LF, Hsieh CM, et al. Positron emission tomography in bronchioloalveolar carcinoma of the lung. Eur J Surg Oncol, 2012, 38(12): 1156-1160.
7.	Suzawa N, Ito M, Qiao S, et al. Assessment of factors influencing FDG uptake in non-small cell lung cancer on PET/CT by investigating histological differences in expression of glucose transporters 1 and 3 and tumour size. Lung Cancer, 2011, 72(2): 191-198.
8.	Wu HB, Wang L, Wang QS, et al. Adenocarcinoma with BAC features presented as the nonsolid nodule is prone to be false-negative on 18F-FDG PET/CT. Biomed Res Int, 2015, 2015: 1-7.
9.	Park CM, Goo JM, Lee HJ, et al. Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up. Radiographics, 2007, 27(2): 391-408.
10.	Weichert W, Warth A. Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma. Curr Opin Pulm Med, 2014, 20(4): 309-316.
11.	Gao JW, Rizzo S, Ma LH, et al. Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology. Transl Lung Cancer Res, 2017, 6(1): 68-75.
12.	Ramer-Quinn DS, Baker RA, Sanders VM. Activated T helper 1 and T helper 2 cells differentially express the beta-2-adrenergic receptor: a mechanism for selective modulation of T helper 1 cell cytokine production. J Immunol, 1997, 159(10): 4857-4867.
13.	Yao F, Yang H, Zhao H. Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules. J Thorac Dis, 2016, 8(3): 469-475.
14.	Tulchinsky M. Applications of ventilation-perfusion scintigraphy in surgical management of chronic obstructive lung disease and cancer. Semin Nucl Med, 2017, 47(6): 671-679.
15.	Iida T, Kohno T, Fujimori S et al. Single-stage video-assisted thoracoscopic surgery: Right upper lobectomy and left lower lobectomy for synchronous bilateral lung cancers. Int J Surg Case Rep, 2017, 33: 55-57.
16.	Nwogu CE, D'Cunha J, Pang H, et al. VATS lobectomy has better perioperative outcomes than open lobectomy: CALGB 31001, an ancillary analysis of CALGB 140202 (Alliance). Ann Thorac Surg, 2015, 99(2): 399-405.
17.	Akter F, Routledge T, Toufektzian L, et al. In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg, 2015, 20(4): 550-555.
18.	Chung JH, Choi YS, Cho JH, et al. Uniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery? Interact Cardiovasc Thorac Surg, 2015, 20(6): 813-819.
19.	Jimenez MF. Uniportal versus standard video-assisted thoracoscopic surgery for lung lobectomy: changing the standards requires scientific evidence. Eur J Cardiothorac Surg, 2015, 47(5): 916.
20.	Liu C, Ma L, Lin F, et al. Single-staged uniportal VATS major pulmonary resection for bilateral synchronous multiple primary lung cancers. J Thorac Dis, 2014, 6(9): 1315-1318.

1. Nakata M, Sawada S, Yamashita M, et al. Surgical treat-ments for multiple primary lung adenocarcinoma of the lung. Ann Thorac Surg, 2004, 78(4): 1194-1199.
2. Matsuge S, Hosokawa Y, Satoh K, et al. Surgical treatment for bilateral multiple lung cancers. Kyobu Geka, 2000, 53(2): 89-94.
3. Iino K, Oda M, Tsunezuka Y, et al. Treatment for bilateral multiple lung cancers. Kyobu Geka, 2002, 55(6): 443-448.
4. Ambrosini V, Nicolini S, Caroli P, et al. PET/CT imaging in different types of lung cancer: an overview. Eur J Radiol, 2012, 81(5): 988-1001.
5. Lee HY, Lee KS. Ground-glass opacity nodules: histopathology, imaging evaluation, and clinical implications. J Thorac Imaging, 2011, 26(2): 106-118.
6. Huang TW, Lin LF, Hsieh CM, et al. Positron emission tomography in bronchioloalveolar carcinoma of the lung. Eur J Surg Oncol, 2012, 38(12): 1156-1160.
7. Suzawa N, Ito M, Qiao S, et al. Assessment of factors influencing FDG uptake in non-small cell lung cancer on PET/CT by investigating histological differences in expression of glucose transporters 1 and 3 and tumour size. Lung Cancer, 2011, 72(2): 191-198.
8. Wu HB, Wang L, Wang QS, et al. Adenocarcinoma with BAC features presented as the nonsolid nodule is prone to be false-negative on 18F-FDG PET/CT. Biomed Res Int, 2015, 2015: 1-7.
9. Park CM, Goo JM, Lee HJ, et al. Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up. Radiographics, 2007, 27(2): 391-408.
10. Weichert W, Warth A. Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma. Curr Opin Pulm Med, 2014, 20(4): 309-316.
11. Gao JW, Rizzo S, Ma LH, et al. Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology. Transl Lung Cancer Res, 2017, 6(1): 68-75.
12. Ramer-Quinn DS, Baker RA, Sanders VM. Activated T helper 1 and T helper 2 cells differentially express the beta-2-adrenergic receptor: a mechanism for selective modulation of T helper 1 cell cytokine production. J Immunol, 1997, 159(10): 4857-4867.
13. Yao F, Yang H, Zhao H. Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules. J Thorac Dis, 2016, 8(3): 469-475.
14. Tulchinsky M. Applications of ventilation-perfusion scintigraphy in surgical management of chronic obstructive lung disease and cancer. Semin Nucl Med, 2017, 47(6): 671-679.
15. Iida T, Kohno T, Fujimori S et al. Single-stage video-assisted thoracoscopic surgery: Right upper lobectomy and left lower lobectomy for synchronous bilateral lung cancers. Int J Surg Case Rep, 2017, 33: 55-57.
16. Nwogu CE, D'Cunha J, Pang H, et al. VATS lobectomy has better perioperative outcomes than open lobectomy: CALGB 31001, an ancillary analysis of CALGB 140202 (Alliance). Ann Thorac Surg, 2015, 99(2): 399-405.
17. Akter F, Routledge T, Toufektzian L, et al. In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg, 2015, 20(4): 550-555.
18. Chung JH, Choi YS, Cho JH, et al. Uniportal video-assisted thoracoscopic lobectomy: an alternative to conventional thoracoscopic lobectomy in lung cancer surgery? Interact Cardiovasc Thorac Surg, 2015, 20(6): 813-819.
19. Jimenez MF. Uniportal versus standard video-assisted thoracoscopic surgery for lung lobectomy: changing the standards requires scientific evidence. Eur J Cardiothorac Surg, 2015, 47(5): 916.
20. Liu C, Ma L, Lin F, et al. Single-staged uniportal VATS major pulmonary resection for bilateral synchronous multiple primary lung cancers. J Thorac Dis, 2014, 6(9): 1315-1318.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Single-stage bilateral pulmonary resections by video-assisted thoracic surgery for multiple small nodules

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