Use of VATS non-anatomic lobar resection in patients with chronic inflammatory lung diseases

Abstract

Objective

The purpose of the present study was to review our experience with non-anatomic lobar resections performed via video-assisted thoracoscopy (VATS) for chronic inflammatory lung disease.

Subjects and methods

Clinical outcomes and surgical skills were analyzed in patients who received VATS non-anatomic lobar resections for chronic inflammatory lung disease during a 6-year period in our institute and met the inclusion criteria

Results

From June 2007 to September 2013, 21 patients underwent VATS non-anatomic pulmonary resections in our department. Of these patients, 14 presented with chronic inflammatory lung disease, including 4 bronchiectasis, 4 lung abscess, 2 pulmonary cyst with infection, 2 lung tuberculosis, and 2 middle lobe syndrome (with special reference to infectious pathogenesis). Ten right and four left lobectomies were performed under general anesthesia. The median operating time was 2.1 h (range, 1.5–4.2 h), the median bleeding was 350 ml (range, 220–840 ml), and the median duration of chest tubes was 3.7 days (range, 3 to 8 days) for this group. The median postoperative hospital stay was 7 days (range 6–12 days), and the median follow-up was 38.7 months. Early complication was present in two patients who developed a persistent air leak. Late complication was present in one patient who developed obstinate cough. No mortality was observed for this group.

Conclusions

The unresectable perihilar lesions in chronic inflammatory lung disease patients may preclude the application of anatomic lobectomy. Under such circumstances, VATS non-anatomic pulmonary resection provides an easy, minimally invasive, and fast and safe technique that promotes smooth postoperative recovery.