Artikel
Extended VATS resections – a single center experience
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Veröffentlicht: | 14. Oktober 2013 |
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Gliederung
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Objective: To analyze feasibility, morbidity and mortality of extended VATS resections in a single center experience.
Methods: Retrospective analysis of a prospectively maintained database.
Results: Starting in 2009, 260 patients were scheduled for anatomical VATS resections. Extended resections were performed in 29 patients: bilobectomy in three, segmental resection in 9, bronchial sleeve resection in 11 (2 circular bronchoplasties, 9 wedge bronchoplasties), pneumonectomy in 5 and pericardial resection in one patient. 20 out of the 29 extended resections were performed within the last 1.5 years of our series. Median operative time was 217 minutes (range, 105–366 minutes). All patients were extubated in the operative room. Median chest tube duration was 4.5 days (range, 2–28 days). Median length of hospital stay was 8 days. There was no in-hospital mortality. Perioperative complications occurred in six patients (20.7%): prolonged air leak in two patients after segmental resections, urinary tract infection in one patient and middle lobe atelectasis after a right upper sleeve lobectomy with the need for bronchoscopy in one patient. On follow-up, one patient developed a second primary tumor on the contralateral lung. All other 26 patients with primary lung cancer are free of recurrent disease. During the study period, three patients planned for VATS lobectomy had to be converted due to oncologic reasons for open pneumonectomy.
Conclusion: With growing experience, extended VATS resections are feasible in selected cases with low perioperative morbidity and mortality and a short length of hospital stay.