Bilateral lung nodules resection by image-guided video-assisted thoracoscopic surgery: a case series

Chu-Chun Liang,Ya-Fu Cheng,Chang-Lun Huang,Bing-Yen Wang,Chi-Hao Liao,Wei-Heng Hung,Heng-Chung Chen

doi:10.1186/s13019-020-01253-5

Abstract

BackgroundWe demonstrated the safety and feasibility of image-guided video-assisted thoracoscopic surgery (iVATS) of bilateral lung lesions in a hybrid operating room.MethodsThis study was a retrospective analysis of a case series. A total of 7 patients with 15 small lung nodules underwent bilateral iVATS between July 2018 and May 2019. All procedures were completed within a single anesthesia procedure and performed in a hybrid operating room that had a cone-beam computed tomography (CT) apparatus equipped with a laser navigation system. The lesion characteristics, operation methods, and peri-operative clinical outcomes were summarized.ResultsA total of 7 patients with 15 resected lung nodules were analyzed. The most common pathological result of our bilateral iVATS was metastasis. The median length of hospital stay was 5 days (range from 3 to 10 days). The median right chest tube duration was 2 days (range from 1 to 8 days), and the median left chest tube duration was 3 days (range from 2 to 5 days). Only one patient had a complication during his hospitalization period. There was no surgery-related mortality observed.ConclusionsFor bilateral pulmonary nodules, the iVATS procedure seems to be a feasible and cost-effective approach.

Highlights

Over the past decades, video-assisted thoracoscopic surgery (VATS) resection for small lung nodules has been adopted more and more widely because of its optimized perioperative outcome and its acceleration of postoperative recovery [1, 2]
Patients who underwent bilateral lung nodule resection suffered from longer surgical duration and hospital stays and higher risks of anesthesiarelated complications, pneumothorax and hemothorax, and there were more concerns about loss of lung functions
We described the feasibility and safety of bilateral small lung nodule resection via image-guided video-assisted thoracoscopic surgery (iVATS) in a hybrid room

Summary

Introduction

Video-assisted thoracoscopic surgery (VATS) resection for small lung nodules has been adopted more and more widely because of its optimized perioperative outcome and its acceleration of postoperative recovery [1, 2]. Several studies about image-guided video assisted thoracoscopic surgery (iVATS) have focused on the application of hybrid operating rooms, which provide multimodality and real-time imaging guidance to improve the localization problems and surgical procedures [1,2,3,4,5,6]. Those studies developed iVATS workflows to combine lesion localization and resection in a single surgical session. We demonstrated the safety and feasibility of image-guided video-assisted thoracoscopic surgery (iVATS) of bilateral lung lesions in a hybrid operating room

Methods

Results

Conclusion