Abstract
BackgroundThere is an increasing incidence rate of ground-glass opacity (GGO), especially for multiple GGOs (≥2). Whether it is safe and feasible to have bilateral simultaneous surgical resection remains unknown. The purpose of this study is to summarize the experience of surgical resection of patients with multiple GGOs in our Hospital in recent years, and to discuss the above questions.MethodsClinical datas of patients who underwent one-stage bilateral uni-portal VATS resections of multiple pulmonary ground glass opacities and had routine pathological examination were collected from May 2016 to May 2019 in our hospital.ResultsA total of 34 patients underwent simultaneous bilateral surgical resection of multiple GGO lesions, 28 were women,6 were men, the average age of total patients was 57.9 ± 6.7 years. All patients underwent bilateral uni-portal video-assisted thoracoscopic surgery (Uni-portal VATS), the average intraoperative blood loss was 100.9 ± 67.7 ml, the average operation time was 140 ± 74.8 min, the average thoracic drainage time was 2.8 ± 3.1 days, and the average postoperative hospital stay was 4.2 ± 4.3 days. Postoperative complications including: 2 cases of infection, 3 cases of atrial fibrillation, and 5 cases of persistent air leakage for more than 3 days. All of them improved after treatment, and there were no serious complications and deaths in perioperative period. A total of 76 GGO lesions were resected, with a total malignancy rate of 81.6%, including 40 were pure GGO, of which 28 were malignant (70%), and the average diameter of them were 9.6 ± 3.8 mm; 36 were mixed GGO, of which 34 were malignant (94.4%), the average diameter of them were 15.6 ± 6.6 mm.Mean postoperative follow-up was 28.4 (range, 3–39) months. There was neither recurrence nor deaths at final follow-up.ConclusionThe malignancy rate of multiple GGOs is high. Therefore, when the lung function is allowed,one-stage bilateral uni-portal VATS can be considered. According to experience of main surgeon and the frozen biopsy, either sub-lobar resection or lobectomy was acceptable. The risk of postoperative complications and the prognosis were optimal.
Highlights
There is an increasing incidence rate of ground-glass opacity (GGO), especially for multiple GGOs (≥2)
We try to obtain a pathological diagnosis through preoperative percutaneous lung biopsy or frozen sections during operation to guide the extent of resection
The mean intraoperative blood loss was 100.9 ± 67.7 ml, the average operation time was 140 ± 74.8 min, the average thoracic drainage time was 2.8 ± 3.1 days, the average postoperative hospital duration was 4.2 ± 4.3 days, and the postoperative complications included 2 cases of pulmonary infection, 3 cases of atrial fibrillation, and persistent air leakage for more than 3 days was observed in 5 cases
Summary
There is an increasing incidence rate of ground-glass opacity (GGO), especially for multiple GGOs (≥2). The purpose of this study is to summarize the experience of surgical resection of patients with multiple GGOs in our Hospital in recent years, and to discuss the above questions. A ground glass opacity (GGO) is defined as a hazy opacity that does not obscure the view of underlying bronchial structures or pulmonary vessels on HRCT [1]. According to whether it contains solid components, it is divided into pure ground glass (pGGO) and mixed ground-glass opacity (mGGO). Our center summarized the experience of simultaneous bilateral surgical resection of multiple GGO patients from May 2016 to May 2019, and conducted a preliminary discussion on the above issues
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