Abstract:
BACKGROUND:Data on advantages of video-assisted thoracoscopic surgery (VATS) lobectomies has been accumulated during the last 10 years then number of thoracoscopic anatomic pulmonary resections rapidly increased. But still there is no agreement about limitations of the method. The most popular "technical contraindications" for VATS anatomic pulmonary resections are: dense pleural adhesions, incompleteness of interlobar fissure, previous chemo- or/and radiotherapy, perivascular or/and peribronchial fibrosis, tumor larger than 5 cm, chest wall involvement, centrally located tumor, severe comorbidity, advanced age, severe COPD and emphysema. Extending of indications for the VATS anatomic pulmonary resection and its influence on the immediate outcomes was investigated. METHODS:Ninety two consecutive cases of VATS anatomic pulmonary resection performed by the single surgeon from January 2012 till December 2013 at the Federal University Hospital #122 in Saint Petersburg, Russia were retrospectively analyzed. Forty three males and 49 females at the age from 21 to 87 years old (mean age 59±7.2). The most of the cases were comprised by lung cancer of I-III stage together with bronchiectasis and tuberculomas. Conversion rate was 3.2% mostly due to perivascular calcification and/or fibrosis. There were no cases of 30-days mortality and readmission. All those patients retrospectively divided into two groups: with standard and extended indications for the VATS lobectomy. Inclusion in "extended" group was made if patients had one or more technical challenges among following: size of the lesion 5 cm and more; strong pleural adhesions and/or "bad fissure"; adjacent structures involvement; hilar or mediastinal lymph nodes enlargement or involvement; centrally located tumors; previous chemo- or chemoradiotherapy or previous thoracic surgery. RESULTS:According to these criteria, 45 standard (S) and 47 extended (E) patients were pair-matched with no statistically significant differences between the groups in common patients' characteristics. Postoperative comparison of "standard" and "expanded" groups revealed some differences in average operation time (152 vs. 189 min), in number of resected mediastinal lymph nodes (10.2 vs. 13.1), and in the mean time before removal of the chest tube (3.9 vs. 5.2 days). But the blood loss, morbidity and the length of hospital stay were almost the same in the two groups. CONCLUSIONS:Extension of indications to VATS lobectomy does not compromise the short-term results. Incompleteness of interlobar fissures, pleural adhesions, preoperative chemotherapy, big size of lesion, and some cases of centrally located tumors are not supposed to be the contraindications for VATS lobectomy. Peribronchial and perivascular lymph node calcification may complicate and even preclude lobectomy by VATS.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Pischik VGdoi
10.3978/j.issn.2072-1439.2014.10.11subject
Has Abstractpub_date
2014-10-01 00:00:00pages
S623-30issue
Suppl 6eissn
2072-1439issn
2077-6624pii
jtd-06-S6-S623journal_volume
6pub_type
杂志文章abstract::With accumulation of experiences in video-assisted thoracic surgery (VATS) lobectomy, complete VATS sleeve lobectomy (SL) has been carried out in more and more medical centers. We here presented a procedure of sleeve right upper lobectomy by complete VATS for a 62-year-old male patient with central squamous cell carci...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.112
更新日期:2018-07-01 00:00:00
abstract:Background:In this retrospective study, we aimed to compare single-port (SP) and two-port (TP) video-assisted thoracic surgery (VATS) for the surgical resection of mediastinal tumor. Methods:Between December 2015 and October 2018, a total of 191 consecutive mediastinal tumor patients who underwent SP- or TP-VATS in th...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.05
更新日期:2019-11-01 00:00:00
abstract::We reported the case of a 70-year-old man who was admitted to neurologic wards for recurrent syncope for 3 years. Unfortunately, just 2 hours after his admission, he suddenly collapsed and failed to return of spontaneous circulation (ROSC) after a 100-minute standard cardiopulmonary resuscitation (CPR). Fortunately, h...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.12.23
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abstract::Quality-focused, cost-effective, patient-centered care is at the forefront of current healthcare reform. Recent data show that enhanced recovery after surgery (ERAS) results in improved surgical outcomes and decreased hospital costs. As a result, ERAS has been widely accepted among multiple surgical subspecialties as ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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abstract::Concomitant occurrence of atrial myxoma and esophageal carcinoma is an extremely rare entity. Here we present two cases of synchronously suffered left atrial myxoma and esophageal carcinoma. Both patients underwent simultaneous resection of two tumors via the right thoraco-abdominal approach and recovered well. ...
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abstract:Background:Pulmonary sclerosing pneumocytoma (PSP) is a rare benign lung tumor. This study investigated the diagnostic experience of PSP and lung cancer. Methods:This study is a retrospective study. We observed the locations of lung lesions, imaging form and clinical symptoms, and recorded the surgical complications t...
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pub_type: 杂志文章
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abstract:Background:Patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations often develop systemic disease progression during treatment with EGFR-tyrosine kinase inhibitors (TKIs). Droplet digital polymerase chain reaction (ddPCR) and amplification refractory mutation system ...
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abstract:Background:In patients with non-small cell lung cancer (NSCLC) the pathologic lymph node status N1 is a heterogeneous entity, and different forms of lymph node involvement may represent different prognoses. For methodological reasons, the 8th edition of the TNM staging system for NSCLC makes no official changes to the ...
journal_title:Journal of thoracic disease
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更新日期:2019-08-01 00:00:00
abstract::The last decade has seen significant advances in our understanding of lung cancer biology and management. Identification of key driver events in lung carcinogenesis has contributed to the development of targeted lung cancer therapies, heralding the era of personalised medicine for lung cancer. As a result, histologica...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.08.43
更新日期:2013-10-01 00:00:00
abstract::Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been traditionally delivered with two independent cannulae at different venous insertion sites. The bicaval dual lumen cannula has gained popularity as a cannula for simultaneous venous drainage and reinfusion of blood via the internal jugular vein (IJV). I...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.02.70
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To investigate diagnostic significance of percutaneous cavitary lavage (PCL) in differential diagnosis of benign and malignant pulmonary cavitary lesions. METHODS:An alternative diagnostic method called PCL was performed on 16 patients having peripherally located pulmonary cavitary lesions with thin walls wh...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2013.08.17
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:We hypothesized that pretreatment with sivelestat therapy could attenuate ventilator-induced lung injury (VILI) and lung inflammation in a rat model. METHODS:The neutrophil elastase inhibitor was administered intraperitoneally 30 min before and at the initiation of ventilation. The rats were categorized as (...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.11.10
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to identify specious radiologic and/or physiologic prognostic marker(s), which lead to optimize of the patient follow-up frequency. METHODS:Eighty consecutive patients with newly diagnosed pulmonary sarcoidosis. Patients underwent chest radiography, high-resolution computed ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.01.17
更新日期:2017-01-01 00:00:00
abstract:Background:Robotic surgery is increasingly used to resect lung cancer. However costs are high. We compared costs and outcomes for robotic surgery, video-assisted thoracic surgery (VATS), and open surgery, to treat non-small cell lung cancer (NSCLC). Methods:We retrospectively assessed 103 consecutive patients given lo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.01.123
更新日期:2018-02-01 00:00:00
abstract::Kehlet first introduced the notion of enhanced recovery after surgery (ERAS). Moreover, in the last years, the fast-track programmes demonstrated a reduction of complications and the hospital length of stay in general surgery. ERAS involves a multidisciplinary to development the value of care introducing the evidence-...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.01.62
更新日期:2019-09-01 00:00:00
abstract::While ionizing radiotherapy (RT) can provide durable local control, the relative radiosensitivity of surrounding organs such as the lungs and heart and the distributed nature of the pleura limit the ability to safely deliver RT for patients with malignant pleural mesothelioma (MPM). Recent advances in the technologica...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.07.65
更新日期:2018-08-01 00:00:00
abstract::Management of pulmonary nodules in terms of diagnosis and intraoperative localization can be challenging, especially in the minimal invasive video-assisted thoracoscopic surgery (VATS) approach, and may be even more difficult with single port VATS with limited access. The ability to localize small lesions intraoperati...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2016.02.27
更新日期:2016-03-01 00:00:00
abstract::The Nuss procedure is a recently developed technique for correction of pectus excavatum. A 23-year-old female patient presented at our emergency department with clinical signs of cardiac tamponade, which required an emergency procedure. Sixteen months ago, she underwent the Nuss procedure with a single bar. Her preope...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.04.11
更新日期:2017-05-01 00:00:00
abstract::In this study, we report the case of a 42-year-old female patient who was diagnosed with hemangioma in the pericardium connected to the main pulmonary artery. Chest CT revealed a hypodense, well-marginated, mass-like lesion, probably connected to the main pulmonary artery, and multiple heterogeneous attenuations were ...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.08.129
更新日期:2017-10-01 00:00:00
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pub_type: 杂志文章
doi:10.21037/jtd.2019.11.01
更新日期:2019-11-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.32
更新日期:2019-12-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.03.102
更新日期:2017-03-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2018.11.32
更新日期:2019-02-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.09.109
更新日期:2017-10-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2015.09.32
更新日期:2015-09-01 00:00:00
abstract::Rituximab, a monoclonal antibody against CD20+ antigen specific B cell, has been increasingly used in the treatment of non-Hodgkin's lymphoma and some other autoimmune diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. It is noted that Rituximab could enhanced the efficacy of CHOP-based che...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2013.08.35
更新日期:2013-08-01 00:00:00
abstract:Background:Sleeve resection allows for preservation of lung parenchyma and improved long-term outcomes when compared with pneumonectomy. Little is known about minimally invasive sleeve resection, especially indications, feasibility, technical aspects, complications, and outcomes. We reviewed our institutional experienc...
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pub_type: 杂志文章
doi:10.21037/jtd.2018.10.97
更新日期:2018-12-01 00:00:00
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pub_type: 杂志文章
doi:10.21037/jtd.2016.01.55
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The use of uniportal video-assisted thoracoscopic surgery (VATS) has been increasing worldwide. Our main goal was to describe the evolution of uniportal surgery in the biggest private hospital in Latin America that is located in São Paulo, Brazil. METHODS:This descriptive and retrospective study included pa...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 评论,杂志文章
doi:10.21037/jtd.2017.08.12
更新日期:2017-09-01 00:00:00