RT Journal Article
SR Electronic
T1 Extended anatomical VATS resections in patients with NSCLC
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3261
VO 44
IS Suppl 58
A1 Uldis Kopeika
A1 Thomas Krbek
A1 Petar Traykov
A1 Joachim Kolb
A1 Maria-L. Mlynek-Kersjes
A1 Kato Kambartel
A1 Thomas Voshaar
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3261.abstract
AB Background: VATS is gaining popularity as a technique for performing anatomical resections in lung cancer patients, showing lesser pain, shorter hospital stay and lower blood loss compared to patients undergoing traditional thoracotomy.Aim: To analyze opportunity, morbidity and mortality of extended anatomical VATS resections.Methods: Retrospective analysis of Lung Cancer centre database.Results: Between 2012 and 2013, 74 patients were scheduled for anatomical VATS resections. Extended resections were performed in 32 patients: bilobectomy in one, segmental resection in 23, lobectomy with chest wall resection in 4, bronchial wedge resection in 3 and intrapericardial resection in one patient. All patients were extubated in the operative room. There was no in-hospital mortality. We observed the below listed complications: chest wall empyema after chest wall reconstruction with synthetic mesh in 1 patient with severe diabetes, bronchus stump insufficiency after VATS segmentectomy in 2 cases. Bronchus stump insufficiency was successfully treated with muscle overlap plastic. Two patients, planed for VATS resection had to be converted due to: 1. massive lymph node silicosis; 2. difficulty in determining segment border.Conclusion: extended anatomical VATS resections are feasible in selected cases with low perioperative morbidity and mortality and a short length of hospital stay. In case of VATS segmental resections patients can not only benefit from a parenchyma-saving resection, but also by the minimally invasive approach. The VATS lobectomy with chest wall resection not only allows to specify the location of the ribs cut, but also to preserve the chest wall muscles, because the rib cut is made from the thorax inside.