Abstract

ObjectivesThe aim of this study is to evaluate the feasibility and safety of video-assisted thoracic surgery (VATS) for the treatment of middle lobe syndrome (MLS) through comparison with thoracotomy during the same period.MethodsWe retrospectively reviewed all consecutive patients with MLS who underwent lobectomy or lingular segmentectomy between December 2005 and November 2015 in a single institute. Thirty patients were enrolled and divided into two groups: VATS group (n = 19) and thoracotomy group (n = 11). Data regarding the patients’ demographics, medical history were collected and statistically compared.ResultsAll patients received successful middle lobe resection or lingular segmentectomy. In terms of operation time, blood transfusion, chest drainage amount, duration of chest drainage and postoperative complications, no significant differences were found between the two groups (p > 0.05). The mean intraoperative blood loss of VATS group was less than thoracotomy group (79.0 ± 63.9 vs. 165 ± 94.9 ml, p = 0.04). In VATS group, the mean length of postoperative hospital stay was 6.0 ± 2.4 days, shorter than that in group thoracotomy (9.0 ± 3.5 days, p = 0.01).ConclusionsVATS was a feasible and safe method for the surgical treatment of MLS in selected patients when no severe calcified lymph nodes surrounding hilus pulmonis was observed by preoperative chest CT scan.

Highlights

  • The name of ‘‘middle lobe syndrome’’ (MLS) was suggested by Graham et al [1]

  • Objectives The aim of this study is to evaluate the feasibility and safety of video-assisted thoracic surgery (VATS) for the treatment of middle lobe syndrome (MLS) through comparison with thoracotomy during the same period

  • We retrospectively reviewed all consecutive patients with MLS who underwent lobectomy or lingular segmentectomy between December 2005 and November 2015 in a single institute

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Summary

Introduction

The name of ‘‘middle lobe syndrome’’ (MLS) was suggested by Graham et al [1]. Extraluminal or intraluminal bronchial obstruction, recurrent atelectasis of the right middle lobe or left lingular segment was defined as MLSJian Li and Chengwu Liu have contributed to this study.[2]. Extraluminal or intraluminal bronchial obstruction, recurrent atelectasis of the right middle lobe or left lingular segment was defined as MLS. Surgical intervention would be necessary for approximately one-third patients with MLS if conservative therapy fails, or complete bronchial obstruction [3,4,5,6]. Lobectomy or lingular segmentectomy was an effective surgical treatment of MLS. In 1948, Graham and Burford reported 12 patients with MLS underwent middle lobe lobectomy and detailed the intraoperative findings. Fretheim and other authors sporadically reported surgical treatment for MLS (see Table 1). Among these studies, the majority of surgical procedures were performed via thoracotomy [7,8,9,10]

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