3 . 2021

Possibilities of video-assisted mini-thoracotomy for lobular lung resections

Abstract Aim. To study experience and determine the possibilities of video-assisted mini-thoracotomy for lobar resections of the lung.
Material and methods. A retrospective study of 104 patients with various pulmonary pathologies, who underwent lobar resection with the use of video-assisted minithoracotomy, including 2 bilobectomy, 18 combined lobectomy, 1 final lobectomy and 83 lobectomy, for the period of 2007-2019. Women were 30 (29%), men - 74 (71%), the average age of the patients was 44±17 years (range 15 to 76 years).
Results. The average duration of surgery was 149.4±37.1 min (95 to 275 min), the average blood loss was 183.0±269.7 ml (20 to 2500 ml), postoperative complications were observed in 8 (7.7%) patients, there was no mortality. Conversion in thoracotomy was required in one case.
Conclusion. The combination of minithoracotomy and video-assisted technique does not replace the VATS method, however significantly expands the surgeon's capabilities and at the same time minimizes the invasiveness of the operation. Clinical trial evidence level - retrospective analysis.

Keywords:videoassisted minithoracotomy, lobectomy, lung tuberculosis, lung cancer

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Pilkevich D.N., Chekasina M.A., Anufrieva S.S. Possibilities of video-assisted mini-thoracotomy for lobular lung resections. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (3): 112-7. DOI: https://doi.org/10.33029/2308-1198-2021-9-3-112-117 (in Russian)

References

1. Ablitsov A.Yu., Ablitsov Yu.A., Vasilashko V.I., Orlov S.S., Nasonov S.N. Minimally invasive lung surgery. From videothoracoscopy to robotic-assisted operations. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra imeni N.I. Pirogova [Bulletin of the National Medical-Surgical Center named after N.I. Pirogov]. 2018; 13 (4): 123-31. DOI: https://doi.org/10.25881/BPNMSC.2018.57.76.025 (in Russian)

2. Abramzon O.M., Kagan 1.1., Lyachshenko S.N., Zaloshkov A.V. Optimization possibilities of mini-access in thoracic surgery. Kreativnaya khirurgiya i onkologiya [Creative Surgery and Oncology]. 2014; (4): 10-3. DOI: https://doi.org/10.24060/2076-3093-2014-0-4-10-13 (in Russian)

3. Giller D.B. Miniinvasive video-assisted accesses in thoracic surgery. Khirurgiya. Zhurnal imeni N.I. Pirogova [Surgery. The Journal Named after N.I. Pirogov]. 2009; (8): 21-8. (in Russian)

4. Pishchik V.G., Zinchenko E.I., Kovalenko A.I., Obornev A.D. Initial experience of thoracoscopic lobectomy performance with bronchoplasty. Vestnik kh-irurgii imeni 1.1. Grekova [Bulletin of Surgery named after 1.1. Grekov]. 2015; 174 (1): 59 - 64. DOI: https://doi.org/10.24884/0042-4625-2015-174-1-59-64 (in Russian)

5. Pishchik V.G., Zinchenko E.I., Obornev A.D., Kovalenko A.I. Video-assisted thoracoscopic anatomic lung resection: experience of 246 operations. Khirurgiya. Zhurnal imeni N.I. Pirogova [Surgery. The Journal Named after N.I. Pirogov]. 2016; (1): 10-5 DOI: https://doi.org/10.17116/hirurgia20161210-15 (in Russian)

6. Sigal R.E., Sigal E.I., Potanin V.P., Potanin A.V., Trofimov K.Yu., Khalimov I.D. Videothoracoscopic lobectomy in the treatment of 1 stage lung cancer. Povolzhskiy onkologicheskiy vestnik [Volga Oncological Bulletin]. 2015; (2): 18-25. (in Russian)

7. Jablonsky P.K., Pishchik V.G. Video thoracoscopy in a modern clinic. Vestnik khirurgii imeni 1.1. Grekova [Bulletin of Surgery named after I.I. Grekov]. 2003; 162 (1): 110-114. (in Russian)

8. Zhestkov K.G., Fursa E.V. Endoscopic surgery of tuberculosis. Endokhirurgiya 21 vek [Endosurgery of the 21^st Century]. 2004; (3): 5-7. (in Russian)

9. Pil’kevich D.N. The minimal invasive and endoscopic lung resection in the diagnosis and treatment of various diseases of the respiratory system. In: XII Congress of the Russian Society of Endoscopic Surgeons. Moscow. 2009. (in Russian)

10. Podobed A.V., Savchenko O.G., Bambiza A.V. Immediate results of videoassisted thoracoscopic lobectomy. Onkologicheskiy zhurnal [Oncological Journal]. 2019; 13 [3 (51)]: 63-70. (in Russian)

11. Abbott G.F., Vlahos I. CT diagnosis and management of focal lung disease. In: Diseases of the Chest, Breast, Heart and Vessels. Cham: Springer, 2019; Chap. 5: 47-55. DOI: https://doi.org/10.1007/978-3-030-11149-6_5

12. Arsen’ev A.I., Nefedov A.O., Barchuk A.A., Tar-kov S.A., Kostitsyn K.A., Nefedova A.V. Uniportal video-assisted thoracoscopic lobectomies in lung cancer management. Vestnik khirurgii imeni I.I. Grekova [Bulletin of Surgery named after I.I. Grekov]. 2017; 176 (5): 33-7. DOI: https://doi.org/10.24884/0042-4625-2017-176-5-33-37 (in Russian)

13. Sokolov A.S. Comparison of videothoracoscopic lobectomy with open thoracotomy in surgical treatment of non-small cell lung cancer I-II stage. Izvestiya Rossiyskoy Voenno-meditsinskoy akademii [News of the Russian Military Medical Academy]. 2019; 2 (1): 167-71. (in Russian)

14. Gonzalez-Rivas D., Delgado M., Fieira E., et al. Single-port video-assisted thoracoscopic lobectomy with pulmonary artery reconstruction. Interact Cardiovasc Thorac Surg. 2013; 17 (5): 889-91. DOI: https://doi.org/10.1093/icvts/ivt340

15. Kaseda S., Aoki T. Video-assisted thoracic surgery lobectomy in conjunction with lymphadenectomy for lung cancer. Nippon Geka Gakkai Zasshi. 2002; 103 (10): 717-21.

16. Walker W.S. VATS lobectomy: the Edinburgh experience. Semin Thorac Cardiovasc Surg. 1998; 10: 291-99.

17. Cattaneo S.M., Park B.J., Wilton A.S., Seshan V.E., Bains M.S., Downey R.J., et al. Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008; 85: 231-6.

18. Thomas P., DoddoIi C., Yena S., Thirion X., Sebag F., Fuentes P., Giudicelli R. VATS is an adequate oncological operation for stage I non-small cell lung cancer. Eur J Cardiothorac Surg. 2002; 21 (6): 1094-9.

19. Izmaylov E.P., Dergal’ S.V., Titov A.N. Choice of access for video-assisted mini-thoracotomy in patients. In: XI Congress of Surgeons of the Russian Federation. Volgograd, 2011: 601-2. (in Russian)

20. Yim A.P.C. VATS major pulmonary resection revisited - controversies techniques, and results. Ann Thorac Surg. 2002; 74 (2): 615 - 23.

21. Giller D.B., Sadovnikova S.S., Papkov A.V., Giller G.V., Glotov A.A. Execution efficiency videoassisted anatomic lung resections. Rossiyskiy mediko-biologiches-kiy vestnik imeni akademika I.P. Pavlova [Russian Medical and Biological Bulletin named after academician I.P. Pavlov]. 2014; 22 (1): 126-31. (in Russian)

22. Daniels L.J., Balderson S.S., Onaitis M.W., D’Amico Th.A. Thoracoscopic lobectomy: a safe and effective strategy for patients with stage I lung cancer. Ann Thorac Surg. 2002; 74 (3): 860-4.