Complete Video-assisted Thoracoscopic Surgery Lobectomy for the Treatment of Bronchiectasis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MIAO Jinbai , SUN Fenghua , ZHANG Wenqian

Department of Thoracic Surgery, Beijing Chaoyang Hospital,　Capital Medical University, Beijing 100020, P. R. China;

Corresponding author：

Keywords：

Video-assisted thoracoscopic surgery; 　Lobectomy; 　Bronchiectasis

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Abstract：　Objective　To compare clinical outcomes of complete video-assisted thoracoscopic surgery （cVATS） lobectomy with routine thoracotomy lobectomy for the treatment of bronchiectasis, and evaluate the feasibility, safety and specific considerations of cVATS lobectomy for the treatment of bronchiectasis.　Methods　We retrospectively analyzed the clinical data of 115 patients who underwent lobectomy for the treatment of bronchiectasis in Beijing Chaoyang Hospital from May 2009 to January 2012. According to the way of operation, these patients were divided into two groups （cVATS group and thoracotomy group）. In the thoracotomy group, there were 62 patients （28 males and 34 females with an age of 46.2±11.9 years） who underwent routine thoracotomy lobectomy. In the cVATS group, there were 53 patients （19 males and 34 females with an age of 45.7±12.2 years） who underwent cVATS lobectomy. Operation time, intra-operative blood loss, postoperative thoracic drainage, complications and hospitalization, and cost of hospitalization were compared between the two groups.　Results　There was no perioperative death in all patients. There was no statistical difference in operation time between the two groups. Intra-operative blood loss of thoracotomy group patients was significantly higher than that of cVATS group patients （228.8±121.7 ml vs. 157.1±123.8 ml, t=2.592, P=0.011）. Postoperative thoracic drainage （866.7±439.5 ml vs. 1 805.3±466.7 ml, t=9.003，P=0.000）, duration of chest tube drainage （6.6±3.3 d vs. 9.8±4.6 d,t=3.339，P=0.001）, and postoperative hospitalization （7.5±2.2 d vs. 11.2±5.4 d, t=3.424，P=0.001） of cVATS group were significantly lower than those of thoracotomy group. The cost of hospitalization of cVATS group was significantly higher than that of thoracotomy group （38 543.6±11 051.8 yuan vs. 30 523.4±10 028.5 yuan，t=3.423, P=0.001）. There was no statistical difference in postoperative complications between the two groups （P＞0.05）. Forty-five patients in cVATS group were followed up for 2 to 14 months. Among them, 42 patients completely had no sputum or haemoptysis and 3 patients still intermittently had some sputum.　Conclusion　cVATS lobectomy is safe and feasible for the treatment of bronchiectasis. Compared with routine thoracotomy lobectomy, cVATS lobectomy does not increase surgical risk, but can significantly reduce operation injury and length of hospital stay. During cVATS, the lung residual should be handled cautiously especially for patients with nonanatomic pulmonary resection, and the non-single-order operation is recommended.

Citation： MIAO Jinbai,SUN Fenghua,ZHANG Wenqian,FU Yili,HU Bin,LI Hui.. Complete Video-assisted Thoracoscopic Surgery Lobectomy for the Treatment of Bronchiectasis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(4): 395-398. doi: Copy

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12.	刘建，闫云龙. 胸腔镜手术治疗支气管扩张症. 临床肺科杂志，2011，16 （5）：689-690．.
13.	Sihoe AD， Shiraishi Y， Yew WW. The current role of thoracic surgery in tuberculosis management. Respirology， 2009， 14 （7）：954-968.
14.	Yan TD， Black D， Bannon PG， et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung Cancer. J Clin Oncol， 2009， 27 （15）：2553-2562.
15.	Yim AP， Ko KM， Ma CC， et al. Thoracoscopic lobectomy for benign diseases. Chest， 1996， 109 （2）：554-556.
16.	杨帆，李晓，王俊，等. 连续300例全胸腔镜肺叶切除术及中期随访分析. 中国胸心血管外科临床杂志， 2011， 18 （2）：95-98．.
17.	王俊，李运，刘军，等. 全胸腔镜下肺叶切除治疗早期非小细胞肺癌. 中华胸心血管外科杂志， 2008， 24 （3）：147-150．.
18.	Zhang P， Zhang F， Jiang S， et al. Video-assisted thoracic surgery for bronchiectasis. Ann Thorac Surg， 2011， 91 （1）：239-243.
19.	周足力，赵辉，李运，等. 全胸腔镜肺叶切除治疗支气管扩张症. 中国微创外科杂志， 2010， 10 （8）：686-687， 699．.
20.	Weber A， Stammberger U， Inci I， et al. Thoracoscopic lobectomy　for benign disease--a single centre study on 64 cases. Eur J　Cardiothorac Surg， 2001， 20 （3）：443-448.
21.	何勇，范士志，蒋耀光. 支气管扩张症138例. 中国胸心血管外科临床杂志， 2001， 8 （4）：274-275．.

1. 　Gorenstein LA， Sonett JR. The surgical management of stage I and stage II lung Cancer. Surg Oncol Clin N Am， 2011， 20 （4）：701-720.
2. 　Goldstraw P， Ball D， Jett JR， et al. Non-small-cell lung cancer.　Lancet， 2011， 378 （9804）：1727-1740.
3. 　Zhu M， Fu XN， Chen X. Lobectomy by video-assisted thoracoscopic surgery （VATS） for early stage of non-small cell lung cancer. Front Med， 2011， 5 （1）：53-60.
4. 　Pasteur MC， Bilton D， Hill AT， et al. British thoracic society guideline for non-CF bronchiectasis. Thorax， 2010， 65 （7）：577.
5. 　Solaini L， Prusciano F， Bagioni P， et al. Video-assisted thoracic surgery （VATS） of the lung：analysis of intraoperative and postoperative　complications over 15 years and review of the literature.Surg Endosc， 2008， 22 （2）：298-310.
6. 　Nakanishi R， Nakagawa M， Tokufuchi H， et al. Video-assisted thoracoscopic lobectomy for clinical stage I non-small cell lung cancer：experience with 111 consecutive patients demonstrating comorbidity. Minerva Chir， 2012， 67 （1）：67-75.
7. 　Jheon S， Yang HC， Cho S. Video-assisted thoracic surgery for lung cancer. Gen Thorac Cardiovasc Surg， 2012， 60 （5）：255-260.
8. 　Li Y， Wang J. Comparison of clinical outcomes for patients with clinical N0 and pathologic N2 non-small cell lung cancer after thoracoscopic lobectomy and open lobectomy：A retrospective analysis of 76 patients. J Surg Oncol， 2012， 22 （10）：100-104.
9. 　彭俊，陈新隆，王平，等. 全电视胸腔镜肺叶切除术在肺部疾病治疗中的应用. 中国胸心血管外科临床杂志， 2011， 18 （5）：429-432．.
10. 　Cobanoglu U， Yalcinkaya I， Er M， et al. Surgery for bronchiectasis：The effect of morphological types to prognosis. Ann Thorac Med， 2011， 6 （1）：25-32.
11. 　Cobanoglu U， Yalcinkaya I， Er M， et al. Surgery for bronchiectasis：The effect of morphological types to prognosis. Ann Thorac Med， 2011， 6 （1）：25-32.
12. 　刘建，闫云龙. 胸腔镜手术治疗支气管扩张症. 临床肺科杂志，2011，16 （5）：689-690．.
13. 　Sihoe AD， Shiraishi Y， Yew WW. The current role of thoracic surgery in tuberculosis management. Respirology， 2009， 14 （7）：954-968.
14. 　Yan TD， Black D， Bannon PG， et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung Cancer. J Clin Oncol， 2009， 27 （15）：2553-2562.
15. 　Yim AP， Ko KM， Ma CC， et al. Thoracoscopic lobectomy for benign diseases. Chest， 1996， 109 （2）：554-556.
16. 　杨帆，李晓，王俊，等. 连续300例全胸腔镜肺叶切除术及中期随访分析. 中国胸心血管外科临床杂志， 2011， 18 （2）：95-98．.
17. 　王俊，李运，刘军，等. 全胸腔镜下肺叶切除治疗早期非小细胞肺癌. 中华胸心血管外科杂志， 2008， 24 （3）：147-150．.
18. 　Zhang P， Zhang F， Jiang S， et al. Video-assisted thoracic surgery for bronchiectasis. Ann Thorac Surg， 2011， 91 （1）：239-243.
19. 　周足力，赵辉，李运，等. 全胸腔镜肺叶切除治疗支气管扩张症. 中国微创外科杂志， 2010， 10 （8）：686-687， 699．.
20. 　Weber A， Stammberger U， Inci I， et al. Thoracoscopic lobectomy　for benign disease--a single centre study on 64 cases. Eur J　Cardiothorac Surg， 2001， 20 （3）：443-448.
21. 　何勇，范士志，蒋耀光. 支气管扩张症138例. 中国胸心血管外科临床杂志， 2001， 8 （4）：274-275．.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Complete Video-assisted Thoracoscopic Surgery Lobectomy for the Treatment of Bronchiectasis

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