Application of video-assisted thoracoscopic anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

AI Bo , ZHANG Ni ,  FU Xiangning , ZHAO Bo , SUN Wei , ZHU Min , CAO Xiaonian , WU Xiaowei

Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P.R.China;

Corresponding author：

FU Xiangning, Email: fuxn2006@aliyun.com

Keywords：

Video-assisted thoracic surgery; anatomic segmentectomy; single-stage bilateral thoracic surgery; localized bronchiectasis; treatment

DOI：

10.7507/1007-4848.201912071

Video：

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Objective To explore the safety and feasibility of the application of video-assisted thoracic surgery (VATS) anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis.Methods From June 2014 to June 2018, 19 patients with bilateral localized bronchiectasis underwent single-stage bilateral thoracic surgery with VATS anatomic segmentectomy, including 11 males and 8 females aged 38.0±12.5 years. The clinical efficacy of the surgery was evaluated.Results All surgeries were successfully completed, of which 17 were bilateral VATS, 2 were unilateral VATS with the other lateral converted to thoracotomy. The average number of bilateral resected segments was 4-8 (5.9±1.2). Mean operation time was 330.0±40.0 min and mean blood loss was 150.0±60.0 mL. Mean ventilator-assisted breathing time was 6.0±1.8 h, mean duration of chest-tube placement was 4.0±1.0 d and mean hospital stay time was 14.0±1.5 d. Three patients suffered pulmonary infection and 1 patient received tracheotomy. No perioperative death occurred. Arterial oxygen pressures on postoperative day (POD) 1 (F=340.18, P<0.05) and POD 3 (F=131.26, P<0.05) were significantly lower than that before operation, arterial carbon dioxide pressures on POD 1 (F=46.62, P<0.05) and POD 3 (F=48.21, P<0.05) were significantly higher than that before operation, and pulse oximeter saturation on POD 1 was significantly lower than that before operation (F=210.82, P<0.05). The patients were followed up for one to five years without recurrence.Conclusion Application of VATS anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis is safe and feasible with strictly selected patients. Postoperative airway management is very important. The surgery is worthy of wide clinical practice.

Citation： AI Bo, ZHANG Ni, FU Xiangning, ZHAO Bo, SUN Wei, ZHU Min, CAO Xiaonian, WU Xiaowei. Application of video-assisted thoracoscopic anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(8): 907-911. doi: 10.7507/1007-4848.201912071 Copy

1.	Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society guideline for bronchiectasis in adults. Thorax, 2019, 74(Suppl 1): 1-69.
2.	廖虎, 肖至兰, 郭成林, 等. 胸腔镜肺切除治疗支气管扩张的安全性与有效性. 中国胸心血管外科临床杂志, 2019, 26(6): 574-577.
3.	吴骁伟, 艾波. 同期双侧胸腔镜手术在肺癌外科治疗中的应用价值. 武汉大学学报(医学版), 2019, 40(6): 906-911.
4.	Wang L, Ge L, Yang X. Combination of subxiphoid and intercostal uniportal video-assisted thoracoscopic surgery for bilateral lung lesions: report of two cases and review of the literature. Postgrad Med, 2017, 129(5): 513-516.
5.	Zhang Z, Liao Y, Ai B, et al. Methylene blue staining: a new technique for identifying intersegmental planes in anatomic segmentectomy. Ann Thorac Surg, 2015, 99(1): 238-42.
6.	Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis, 2018, 10(4): 2331-2337.
7.	Fernandes P, Lareiro S, Vouga L, et al. Uniportal video-assisted thorascoscopic surgery--the new paradigm in the surgical treatment of lung cancer. Rev Port Cir Cardiotorac Vasc, 2017, 24(3-4): 127.
8.	Cheufou DH, Mardanzai K, Ploenes T, et al. Effectiveness of robotic lobectomy-outcome and learning curve in a high volume center. Thorac Cardiovasc Surg, 2019, 67(7): 573-577.
9.	Sanchez-Lorente D, Guzman R, Boada M, et al. Is it appropriate to perform video-assisted thoracoscopic surgery for advanced lung cancer. Future Oncol, 2018, 14(6s): 29-31.
10.	Churchill ED, Belsey R. Segmental pneumonectomy in bronchiectasis: the lingula segment of the left upper lobe. Ann Surg, 1939, 109(4): 481-99.
11.	齐海亮, 李明珠, 杜秀然, 等. 全胸腔镜解剖性肺段切除术治疗结核性支气管扩张症. 中国微创外科杂志, 2018, 18(9): 802-805.
12.	Geraci TC, Ferrari-Light D, Kent A, et al. Technique, outcomes with navigational bronchoscopy using indocyanine green for robotic segmentectomy. Ann Thorac Surg, 2019, 108(2): 363-369.
13.	Bédat B, Abdelnour-Berchtold E, Perneger T, et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study. J Cardiothorac Surg, 2019, 14(1): 189.
14.	Baysungur V, Dogruyol T, Ocakcioglu I, et al. The feasibility of thoracoscopic resection in bronchiectasis. Surg Laparosc Endosc Percutan Tech, 2017, 27(3): 194-196.
15.	Bertolaccini L, Batirel H, Brunelli A, et al. Corrigendum to uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 56: 224-229.
16.	Siu I, Li Z, Ng C. Latest technology in minimally invasive thoracic surgery. Ann Transl Med, 2019, 7(2): 35.
17.	Xu G, Chen C, Zheng W, et al. Application of the IQQA-3D imaging interpretation and analysis system in uniportal video-assisted thoracoscopic anatomical segmentectomy: a series study. J Thorac Dis, 2019, 11(5): 2058-2066.
18.	Kim HK, Han KN. Uniportal video-assisted thoracoscopic surgery segmentectomy. Thorac Surg Clin, 2017, 27(4): 387-398.
19.	Matsuura Y, Mun M, Ichinose J, et al. Recent fluorescence-based optical imaging for video-assisted thoracoscopic surgery segmentectomy. Ann Transl Med, 2019, 7(2): 32.

1. Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society guideline for bronchiectasis in adults. Thorax, 2019, 74(Suppl 1): 1-69.
2. 廖虎, 肖至兰, 郭成林, 等. 胸腔镜肺切除治疗支气管扩张的安全性与有效性. 中国胸心血管外科临床杂志, 2019, 26(6): 574-577.
3. 吴骁伟, 艾波. 同期双侧胸腔镜手术在肺癌外科治疗中的应用价值. 武汉大学学报(医学版), 2019, 40(6): 906-911.
4. Wang L, Ge L, Yang X. Combination of subxiphoid and intercostal uniportal video-assisted thoracoscopic surgery for bilateral lung lesions: report of two cases and review of the literature. Postgrad Med, 2017, 129(5): 513-516.
5. Zhang Z, Liao Y, Ai B, et al. Methylene blue staining: a new technique for identifying intersegmental planes in anatomic segmentectomy. Ann Thorac Surg, 2015, 99(1): 238-42.
6. Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis, 2018, 10(4): 2331-2337.
7. Fernandes P, Lareiro S, Vouga L, et al. Uniportal video-assisted thorascoscopic surgery--the new paradigm in the surgical treatment of lung cancer. Rev Port Cir Cardiotorac Vasc, 2017, 24(3-4): 127.
8. Cheufou DH, Mardanzai K, Ploenes T, et al. Effectiveness of robotic lobectomy-outcome and learning curve in a high volume center. Thorac Cardiovasc Surg, 2019, 67(7): 573-577.
9. Sanchez-Lorente D, Guzman R, Boada M, et al. Is it appropriate to perform video-assisted thoracoscopic surgery for advanced lung cancer. Future Oncol, 2018, 14(6s): 29-31.
10. Churchill ED, Belsey R. Segmental pneumonectomy in bronchiectasis: the lingula segment of the left upper lobe. Ann Surg, 1939, 109(4): 481-99.
11. 齐海亮, 李明珠, 杜秀然, 等. 全胸腔镜解剖性肺段切除术治疗结核性支气管扩张症. 中国微创外科杂志, 2018, 18(9): 802-805.
12. Geraci TC, Ferrari-Light D, Kent A, et al. Technique, outcomes with navigational bronchoscopy using indocyanine green for robotic segmentectomy. Ann Thorac Surg, 2019, 108(2): 363-369.
13. Bédat B, Abdelnour-Berchtold E, Perneger T, et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study. J Cardiothorac Surg, 2019, 14(1): 189.
14. Baysungur V, Dogruyol T, Ocakcioglu I, et al. The feasibility of thoracoscopic resection in bronchiectasis. Surg Laparosc Endosc Percutan Tech, 2017, 27(3): 194-196.
15. Bertolaccini L, Batirel H, Brunelli A, et al. Corrigendum to uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 56: 224-229.
16. Siu I, Li Z, Ng C. Latest technology in minimally invasive thoracic surgery. Ann Transl Med, 2019, 7(2): 35.
17. Xu G, Chen C, Zheng W, et al. Application of the IQQA-3D imaging interpretation and analysis system in uniportal video-assisted thoracoscopic anatomical segmentectomy: a series study. J Thorac Dis, 2019, 11(5): 2058-2066.
18. Kim HK, Han KN. Uniportal video-assisted thoracoscopic surgery segmentectomy. Thorac Surg Clin, 2017, 27(4): 387-398.
19. Matsuura Y, Mun M, Ichinose J, et al. Recent fluorescence-based optical imaging for video-assisted thoracoscopic surgery segmentectomy. Ann Transl Med, 2019, 7(2): 32.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of video-assisted thoracoscopic anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis

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