Video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WEI Ruishi ^1,2 , ZHUANG Xiaofei ³ , GUO Shiping ³ ,  YU Jianrong ² ,  LI Xinhua ¹

1. Department of Thoracic Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, P.R.China;
2. Department of Thoracic Surgery, Changzhou Cancer Hospital Affiliated to Soochow University, Changzhou, 213001, Jiangsu, P.R.China;
3. Department of Thoracic Surgery, Shanxi Cancer Hospital, Taiyuan, 030013, P.R.China;

Corresponding?author：

YU Jianrong, Email: 390023627@qq.com; LI Xinhua, Email: kunkung_001@163.com

Keywords：

Central non-small cell lung cancer; total thoracoscopy; thoracotomy; sleeve resection; lobectomy

DOI：

10.7507/1007-4848.202004077

Video：

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Objective To evaluate the efficacy of video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer.Methods The clinical data of 105 patients with central non-small cell lung cancer who underwent sleeve lobectomy surgery in the Second Hospital of Shanxi Medical University and Shanxi Cancer Hospital from December 2014 to December 2019 were retrospectively analyzed, including 83 males and 22 females, with an average age of 57.4 (32.6-77.8) years and weight of 62.5 (52.4-79.1) kg. Thirty-five patients received video-assisted thoracoscopic sleeve lobectomy (a group A), and 70 patients received traditional thoracotomy sleeve lobectomy (a group B). The operation time, intraoperative blood loss, number of lymph node dissection, postoperative complication rate, early postoperative mortality, total thoracic drainage volume at 24 hours, time of indwelling chest tube after operation, pain score at 24 hours after operation, postoperative hospital stay, postoperative short-term (1 month, 6 months and 1 year) quality of life score and postoperative 3-year survival rate of two groups were compared.Results There was statistical difference in the operation time (228.1±24.7 min vs. 175.0±23.7 min, P=0.02), postoperative complication rate (28.6% vs. 34.3%, P=0.04), postoperative pain score at 24 h (3.6±3.5 points vs. 5.9±2.0 points, P=0.03) and postoperative indwelling chest tube time (5.0±2.9 d vs. 8.4±2.1 d, P=0.04) between the two groups. There was no statistical difference in the intraoperative blood loss (182.5±36.9 mL vs. 189.8±27.5 mL, P=0.34), number of lymph node dissections (11.1±2.6 vs. 12.3±1.9, P=0.49), early postoperative mortality (2.9% vs. 4.3%, P=0.31), total thoracic drainage volume at 24 h after surgery (346.8±91.1 mL vs. 329.8±101.4 mL, P=0.27), postoperative hospital stay (7.9±4.2 d vs. 8.5±3.4 d, P=0.39) and 3-year postoperative survival rate (68.6% vs. 72.9%, P=0.82) between the two groups.Conclusion Video-assisted thoracoscopic sleeve lobectomy for the treatment of central non-small cell lung cancer is safe and feasible. Compared with traditional thoracotomy for sleeve lobectomy, fewer postoperative complications occur, body recovers faster and the quality of life is higher within the postoperative 6 months. Besides, the 3-year survival rate can achieve similar oncological prognosis results.

Citation： WEI Ruishi, ZHUANG Xiaofei, GUO Shiping, YU Jianrong, LI Xinhua. Video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(6): 720-724. doi: 10.7507/1007-4848.202004077 Copy

1.	潘茂杰, 魏煜程. 袖式肺葉切除術在非小細胞肺癌中的應用. 中國胸心血管外科臨床雜志, 2018, 25(6): 526-532.
2.	Yang C, Abu Akar F, Chen J, et al. Right sleeve pneumonectomy via uniportal video-assisted thoracoscopic approach. J Thorac Dis, 2018, 10(5): 391-396.
3.	楊德松, 周勇, 王文祥, 等. 全胸腔鏡支氣管袖式/成形肺葉切除治療中央型肺癌 120 例. 中國微創外科雜志, 2020, 20(5): 401-404.
4.	Davoli F, Bertolaccini L, Pardolesi A, et al. Video-assisted thoracoscopic surgery bronchial sleeve lobectomy. J Vis Surg, 2017, 3: 41.
5.	Zhang Z, Huang Q, Liao Y, et al. Application of the "continuous suture dividing and equal suture tightening" method in video-assisted thoracoscopic surgery sleeve lobectomy. J Thorac Dis, 2018, 10(9): 5199-5207.
6.	Chen H, Xu G, Zheng B, et al. Initial experience of single-port video-assisted thoracoscopic surgery sleeve lobectomy and systematic mediastinal lymphadenectomy for non-small-cell lung cancer. J Thorac Dis, 2016, 8(8): 2196-2202.
7.	Toyooka S, Soh J, Yamamoto H, et al. Extended sleeve lobectomy after induction chemoradiotherapy for non-small cell lung cancer. Surg Today, 2015, 45(9): 1121-1126.
8.	Waseda R, Iwasaki A. Extended sleeve lobectomy: Its place in surgical therapy for centrally located non-small cell lung cancer and a review of technical aspects. J Thorac Dis, 2018, 10(Suppl 26): S3103-S3108.
9.	Reardon MJ, Walkes JC, Rice DC. Autotransplantation for central non-small-cell lung cancer in a patient with poor pulmonary function. Tex Heart Inst J, 2004, 31(4): 360-362.
10.	劉倫旭, 劉成武. 胸腔鏡肺葉切除方法的探索. 中國胸心血管外科臨床雜志, 2014, 21(4): 431-434.
11.	Schinkel C, Mueller C, Reinmiedl J, et al. Morbidity and survival after bronchoplastic surgery for non-small-cell lung cancer. J Cardiovasc Surg (Torino), 2000, 41(4): 637-640.
12.	張雙平, 郭石平, 廉建紅, 等. 全胸腔鏡支氣管袖式肺葉切除術治療中心型非小細胞肺癌效果及安全性. 腫瘤研究與臨床, 2020, 32(1): 27-31.
13.	Qiu T, Zhao Y, Xuan Y, et al. Robotic-assisted double-sleeve lobectomy. J Thorac Dis, 2017, 9(1): E21-E25.
14.	Jiao W, Zhao Y, Qiu T, et al. Robotic bronchial sleeve lobectomy for central lung tumors: Technique and outcome. Ann Thorac Surg, 2019, 108(1): 211-218.
15.	黃靖, 陳健, 陳志剛, 等. 單孔胸腔鏡雙袖式肺葉切除手術的臨床分析. 第二軍醫大學學報, 2019, 40(8): 839-842.
16.	瞿冀琛, 朱余明, 趙德平, 等. 單孔全胸腔鏡下袖式肺葉切除術 114 例臨床分析. 中華外科雜志, 2018, 56(12): 938-940.

1. 潘茂杰, 魏煜程. 袖式肺葉切除術在非小細胞肺癌中的應用. 中國胸心血管外科臨床雜志, 2018, 25(6): 526-532.
2. Yang C, Abu Akar F, Chen J, et al. Right sleeve pneumonectomy via uniportal video-assisted thoracoscopic approach. J Thorac Dis, 2018, 10(5): 391-396.
3. 楊德松, 周勇, 王文祥, 等. 全胸腔鏡支氣管袖式/成形肺葉切除治療中央型肺癌 120 例. 中國微創外科雜志, 2020, 20(5): 401-404.
4. Davoli F, Bertolaccini L, Pardolesi A, et al. Video-assisted thoracoscopic surgery bronchial sleeve lobectomy. J Vis Surg, 2017, 3: 41.
5. Zhang Z, Huang Q, Liao Y, et al. Application of the "continuous suture dividing and equal suture tightening" method in video-assisted thoracoscopic surgery sleeve lobectomy. J Thorac Dis, 2018, 10(9): 5199-5207.
6. Chen H, Xu G, Zheng B, et al. Initial experience of single-port video-assisted thoracoscopic surgery sleeve lobectomy and systematic mediastinal lymphadenectomy for non-small-cell lung cancer. J Thorac Dis, 2016, 8(8): 2196-2202.
7. Toyooka S, Soh J, Yamamoto H, et al. Extended sleeve lobectomy after induction chemoradiotherapy for non-small cell lung cancer. Surg Today, 2015, 45(9): 1121-1126.
8. Waseda R, Iwasaki A. Extended sleeve lobectomy: Its place in surgical therapy for centrally located non-small cell lung cancer and a review of technical aspects. J Thorac Dis, 2018, 10(Suppl 26): S3103-S3108.
9. Reardon MJ, Walkes JC, Rice DC. Autotransplantation for central non-small-cell lung cancer in a patient with poor pulmonary function. Tex Heart Inst J, 2004, 31(4): 360-362.
10. 劉倫旭, 劉成武. 胸腔鏡肺葉切除方法的探索. 中國胸心血管外科臨床雜志, 2014, 21(4): 431-434.
11. Schinkel C, Mueller C, Reinmiedl J, et al. Morbidity and survival after bronchoplastic surgery for non-small-cell lung cancer. J Cardiovasc Surg (Torino), 2000, 41(4): 637-640.
12. 張雙平, 郭石平, 廉建紅, 等. 全胸腔鏡支氣管袖式肺葉切除術治療中心型非小細胞肺癌效果及安全性. 腫瘤研究與臨床, 2020, 32(1): 27-31.
13. Qiu T, Zhao Y, Xuan Y, et al. Robotic-assisted double-sleeve lobectomy. J Thorac Dis, 2017, 9(1): E21-E25.
14. Jiao W, Zhao Y, Qiu T, et al. Robotic bronchial sleeve lobectomy for central lung tumors: Technique and outcome. Ann Thorac Surg, 2019, 108(1): 211-218.
15. 黃靖, 陳健, 陳志剛, 等. 單孔胸腔鏡雙袖式肺葉切除手術的臨床分析. 第二軍醫大學學報, 2019, 40(8): 839-842.
16. 瞿冀琛, 朱余明, 趙德平, 等. 單孔全胸腔鏡下袖式肺葉切除術 114 例臨床分析. 中華外科雜志, 2018, 56(12): 938-940.

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Video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer: A retrospective cohort study

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