Application Of Video-assisted Thoracoscopic Surgery Research Articles

Clinical evaluation of the impact of mediastinal tumour size on the subxiphoid approach video-assisted thoracoscopic surgery.

The application of video-assisted thoracoscopic surgery (VATS) for relatively large mediastinal tumours (≥5.0 cm) has been a subject of debate, and few studies have investigated the subxiphoid approach VATS in different tumour size categories. The study aims to compare the efficacy of the subxiphoid approach VATS for achieving curative outcomes based on tumour size categories (<3.0, 3.0-4.9 and 5.0-10.0 cm). A total of 165 patients with anterior mediastinal tumours who underwent surgery at our hospital between January 2018 and July 2022 were consecutively enrolled, categorized according to tumour size-group A (<3.0 cm): 58, group B (3.0-4.9 cm): 70 and group C (5.0-10.0 cm): 37. Clinical baseline data, intraoperative and postoperative outcomes, and postoperative complications were analysed. The study revealed significant differences in operation time among the 3 groups (group A: 103.4 ± 36.1, group B: 106.4 ± 35.2, group C: 127.4 ± 44.8; P < 0.05) as well as in the volume of drainage (group A: 273.3 ± 162.0, group B: 411.9 ± 342.6, group C: 509.7 ± 543.7; P < 0.05). However, no differences were seen in blood loss, drainage duration, postoperative hospital stay and duration of postoperative oral analgesics. Additionally, the incidence of postoperative complications did not exhibit significant differences across these groups. Subxiphoid approach VATS is considered a feasible and safe surgical method for large-sized anterior mediastinal tumours (5.0-10.0 cm) with no invasion to the surrounding tissues and organs.

Short- and medium-term outcomes of video-assisted thoracoscopic surgery versus thoracotomy for carinal lung resection combined with carina reconstruction in locally advanced non-small cell lung cancer patients.

The application of video-assisted thoracoscopic surgery (VATS) for complex carina surgeries in treating non-small cell lung cancer (NSCLC) patients with involved carina is controversial. This study compared short- and medium-term outcomes of VATS versus thoracotomy for carinal lung resection with carina reconstruction in treating locally advanced NSCLC, aiming to assess the potential benefit of VATS over thoracotomy for these patients. A total of 37 consecutive NSCLC cases receiving VATS (n = 14) or thoracotomy (n = 23) for carinal lung resection with carina reconstruction from 2016 to 2021 were retrospectively identified. Baseline clinicopathological characteristics, perioperative outcomes, and survival profiles were investigated. Patients in the VATS and thoracotomy groups had comparable baseline clinicopathological characteristics (all p > 0.050). VATS decreased postoperative drainage volume compared with thoracotomy (1280 [1170-1510] vs. 1795 [1510-1905] mL, p = 0.012). Regarding surgical-related pains, VATS reduced numeric rating scale scores on the postoperative day 1 (4 [3, 4] vs. 5 [4, 5], p = 0.021) and day 2 (3 [3, 4] vs. 5 [3-5], p = 0.023) than thoracotomy. No difference was found between the VATS and thoracotomy groups in other perioperative outcomes, postoperative complications, and assessment of lymph nodes (LNs) and LN stations (all p > 0.050). Moreover, patients in the two groups had comparable 3-year disease-free survival (DFS), overall survival (OS), and recurrence and mortality patterns. Further subgroup and Cox hazards regression analyses also observed no difference in DFS or OS between the two groups. VATS reduced postoperative drainage volume and ameliorated surgical-related pain, and achieved comparable medium-term survival compared to thoracotomy for carinal lung resection with carina reconstruction in treating locally advanced NSCLC.

Video-assisted thoracoscopic surgery is a safe and effective method to treat intrathoracic unicentric Castleman\u2019s disease

BackgroundCastleman’s disease (CD) is a rare non-clonal lymphadenopathy. Application of video-assisted thoracoscopic surgery (VATs) in intrathoracic unicentric Castleman’s disease (UCD) is rarely reported. This study is aimed to clarify the role of VATs for diagnosis and treatment in intrathoracic UCD.MethodsThe authors reviewed and identified patients who had received a histologic diagnosis of CD through VATs at our hospital from January2010 to June 2018. Clinical and radiologic variables, histopathology, type of approach, complications, and long-term effect were analyzed to evaluate the safety and efficacy of VATs.ResultsA total of 10 patients were included in this study, with 8 hyaline vascular type and 2 plasma cell type. The mean maximum diameter of the lesions was 4.66 cm. Nine cases underwent complete surgical excision by VATs, and 1 case was converted to thoracotomy. All patients had no postoperative complications. With a median follow-up of 5 years (range: 1–9 years), no tumor recurrence was found in 9 patients receiving complete tumor resection, and 1 patient with incomplete tumor resection remained symptom free without clinical or radiographic progression.ConclusionsVATs is an alternative, minimally invasive technique for the diagnosis and treatment in patients with intrathoracic UCD.

Safety and feasibility of video-assisted thoracoscopic surgery for stage IIIA lung cancer.

The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery (VATS) radical treatment for patients with stage IIIA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery. A total of 51 patients with radiologically or mediastinoscopically confirmed stage IIIA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment. The operative time, intraoperative blood loss/complications, postoperative recovery, postoperative complications, and lymph node dissection were recorded and analyzed. This study was regarded as successful if the surgical success rate reached 90% or higher. A total of 51 patients with non-small cell lung cancer (NSCLC) were enrolled in this study from March 2009 to February 2010. The median post-operative follow-up duration was 50.5 months. Of these 51 patients, 41 (80.4%) had N2 lymph node metastases. All patients underwent the thoracoscopic surgeries, among whom 50 (98%) received pulmonary lobectomy and mediastinal lymph node dissection completely under the thoracoscope, 6 had their incisions extended to about 6 cm due to larger tumor sizes, and 1 had his surgery performed using a 12 cm small incision for handling the adhesions between lymph nodes and blood vessels. No patient was converted to conventional open thoracotomy. No perioperative death was noted. One patient received a second surgery on the second post-operative day due to large drainage (>1,000 mL), and the postoperative recovery was satisfactory. Up to 45 patients (88.2%) did not suffer from any perioperative complication, and 6 (11.8%) experienced one or more complications. VATS radical treatment is a safe and feasible treatment for stage IIIA lung cancer.

Advances in the Use of Video-Assisted Thoracoscopic Lobectomy in Lung Cancer: Sleeve Bronchoplasty and Arterioplasty

SUMMARY This article focuses on the technical strategies for performing sleeve bronchoplasty and pulmonary arterioplasty as advances in the application of video-assisted thoracoscopic surgery (VATS) as lobectomy with bronchovascular reconstruction is a favorable alternative to pneumonectomy in terms of the pulmonary function. When performing VATS sleeve bronchoplasty or arterioplasty, several technical issues should be discussed, including how to reduce the anastomotic tension of the airway, perform bronchial anastomosis, and clamp the pulmonary artery and select the type of vascular clamp. The traction device technique and continuous suture technique are thought to help surgeons perform VATS sleeve bronchoplasty, while cross-clamping of the pulmonary artery using thoracoscopic instruments aids in carrying out VATS arterioplasty.

Video-assisted thoracoscopic surgery in thoracic oncology

Objective The purpose of this study was to summarize and discuss the application of video-assisted thoracoscopic surgery (VATS) in the treatment of 58 chest cancers.

Video-assisted thoracoscopic lobectomy with bronchoplasty for lung cancer: tip regarding bronchial anastomosis

No study has discussed the application of video-assisted thoracoscopic surgery (VATS) to bronchoplasty or the handling of a needle and forceps in a bronchial anastomosis. We use the following steps for bronchial anastomosis: Insert the needle and forceps vertical to the bronchial wall, move them in such way as to scoop something up, rotate and turn around, repeat the second step, and pull from the bronchial wall along the curvature of the needle. Handling the needle forceps along the curvature of the needle is critically important.

Application of video-assisted thoracoscopic surgery to diagnose and treatment solitary pulmonary nodule

目的 探讨电视胸腔镜(VATS)在孤立性肺结节(SPN)诊治中的应用价值.方法 对38例SPN患者进行VATS下肺叶楔形切除并送冰冻病理诊断.若为良性病变则终止手术;若为恶性肿瘤则VATS辅助小切口下行肺叶切除及系统性纵隔淋巴结清扫.结果 良性SPN 7例,转移性SPN 2例,均在VATS下行肺叶楔形切除术,原发恶性SPN 29例,其中27例在VATS辅助小切口下行肺叶切除及系统性纵隔淋巴结清扫,2例患者因高龄混合性通气功能障碍行VATS下肺叶楔形切除术.所有病例均手术过程顺利,无手术死亡,无术中、术后严重并发症.术中冰冻报告与术后病理符合率达100%.结论 VATS应用于SPN的诊治能最大限度地减少创伤和并发症,VATS下肺叶楔形切除术可能代替传统的开胸肺叶切除术,成为诊治SPN的基本术式。

Application of video-assisted thoracoscopic surgery in grass-roots hospital

目的 探讨电视胸腔镜手术(VATS)在基层医院的应用.方法 总结电视胸腔镜或辅助小切口(VAMT)手术46例,包括肺大疱切除、肺楔形或肺叶切除、肺减容术、食管切除、血胸和心包开窗手术等.结果 全组手术无死亡.围术期并发症2例,占4.3%,均治愈.随访6个月.术后恢复良好,无复发.结论 只要注意预防和减少并发症的发生,VATS在基层医院的应用是安全可行的。

Application of video-assisted thoracoscopic surgery in thoracic tumors

With the improvement of instrument and operative technique, video-assisted thoracoscopy is more and more widely used. The aim of this study is to summarize and discuss the results of video-assisted thoracoscopic surgery (VATS) in 76 patients with thoracic tumors. The data of 76 cases were analyzed retrospectively. From July 1997 to June 2004, 76 patients (46 men and 30 women) with thoracic tumors underwent VATS for peripheral pulmonary nodules (52), leiomyoma of esophagus (10), mediastinal lymphadenectasis (6), malignant pleural fluid (5), bronchogenic cyst (1), mediastinal cyst (1), neurofibroma (1). All procedures were performed successfully under VATS except for 8 cases, who were converted to thoracotomy for lung cancer. There was no mortality or severe complication in this series. VATS is a safe and effective technique in selected patients with thoracic lesions. The overall incidence of perioperative complication is low. VATS has obvious advantages in treatment of benign thoracic lesions, however, the indications should be selected carefully for malignant tumors.

Results of Application of Video-Assisted Thoracoscopic Surgery for the Treatment of Empyema Thoracis

Background: Since video-assisted thoracoscopic surgery (VATS) was introduced as a new treatment modality for empyema thoracis, numerous reports have suggested that VATS is a more effective treatment method than the traditional methods that mainly use antibiotics and drainage apparatus. However, no confirmative evidence of the superiority of VATS over the traditional method has been provided yet. Methods: We attempted to evaluate the efficacy of VATS for the treatment of empyema thoracis by reviewing past medical records and simple chest films. First, we divided the patients into two groups based on the treatment method: group A of 15 patients who were treated with the traditional method between January 2001 and December 2003, and group B of 9 patients who were treated with VATS between December 2003 and August 2006. The final outcomes used in this study were the number of days of hospital stay, chest tube duration, leukocytosis duration, febrile duration, and intravenous antibiotics usage duration. In addition, radiological improvements were compared. Results: The mean age(standard deviation) of 11 men and 4 women in group A was years, and of 9 men and 2 women in group B was years. Group B had a significantly shorter hospital stay ( vs. days; p=0.014), shorter chest tube duration ( vs. days; p=0.039), shorter leukocytosis duration ( vs. days; p=0.008), shorter febrile duration ( vs. days; p=0.004), and shorter duration of intravenous antibiotics usage ( vs. days; p=0.018). However, radiological improvements did not show any statistical differences. Conclusion: Early application of VATS for empyema thoracis treatment reduced hospital stay, thoracostomy tube duration, leukocytosis duration, febrile duration, and antibiotics usage duration in comparison with the traditional methods. The early performing of VATS might be an effective treatment modality for empyema thoracis.

Clinical application of video-assisted thoracoscopic surgery with small incision

目的 评价小切口胸腔镜手术的效果及实用性.方法 42例患者均采用小切口胸腔镜术式手术,以普通手术器械直视下操作为主.结果所有患者均治愈,除少数患者并发少量胸腔积液外,无严重并发症,与传统胸腔镜手术相比,手术难度下降,手术时间缩短,医疗费大大降低.结论小切口胸腔镜手术,操作简单,疗效满意,费用低廉,值得推广。