A dense fissure is not a contra-indication for uniportal thoracoscopic lobectomy.
Dense fissure
lobectomy
thoracoscopy
uniport
Journal
Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
03
08
2022
accepted:
04
10
2022
entrez:
17
1
2023
pubmed:
18
1
2023
medline:
18
1
2023
Statut:
ppublish
Résumé
A dense fissure is a main cause of a postoperative prolonged air leak (PAL). Such a fissure, if exposed, sometimes incidentally injures the pulmonary artery. We investigated whether uniportal thoracoscopic lobectomy which is considered technically more difficult than the conventional multiportal approach was appropriate for patients with dense fissures. From February 2019 to January 2022, 140 patients with primary lung cancer underwent uniportal thoracoscopic lobectomy with ≥ ND2a-1 lymphadenectomy. Patients were divided into those with dense (n=22) and separated (n=118) fissures. All dense fissures were treated using a fissureless technique without exposure of the pulmonary artery. We compared the characteristics and perioperative results of the two groups. We used multivariate analysis to identify factors predictive of PAL. Although dense fissures were significantly associated with right upper lobectomies, the other patient characteristics and perioperative results were similar between the two groups. No significant pulmonary artery injuries occurred in the fissureless group. In subgroup analyses of right upper lobectomy patients, we found no other significant between-group differences in patient characteristics or perioperative results. In multivariate analyses, right upper lobectomy [odds ratio (OR): 0.047, 95% confidence interval (CI): 0.0044-0.49, P=0.011] or smoking index (OR: 1.03, 95% CI: 1-1.07, P=0.048) was the factor predictive of PAL. A dense fissure is not a contraindication for uniportal thoracoscopic lobectomy using the fissureless technique, which is thus safe.
Sections du résumé
Background
UNASSIGNED
A dense fissure is a main cause of a postoperative prolonged air leak (PAL). Such a fissure, if exposed, sometimes incidentally injures the pulmonary artery. We investigated whether uniportal thoracoscopic lobectomy which is considered technically more difficult than the conventional multiportal approach was appropriate for patients with dense fissures.
Methods
UNASSIGNED
From February 2019 to January 2022, 140 patients with primary lung cancer underwent uniportal thoracoscopic lobectomy with ≥ ND2a-1 lymphadenectomy. Patients were divided into those with dense (n=22) and separated (n=118) fissures. All dense fissures were treated using a fissureless technique without exposure of the pulmonary artery. We compared the characteristics and perioperative results of the two groups. We used multivariate analysis to identify factors predictive of PAL.
Results
UNASSIGNED
Although dense fissures were significantly associated with right upper lobectomies, the other patient characteristics and perioperative results were similar between the two groups. No significant pulmonary artery injuries occurred in the fissureless group. In subgroup analyses of right upper lobectomy patients, we found no other significant between-group differences in patient characteristics or perioperative results. In multivariate analyses, right upper lobectomy [odds ratio (OR): 0.047, 95% confidence interval (CI): 0.0044-0.49, P=0.011] or smoking index (OR: 1.03, 95% CI: 1-1.07, P=0.048) was the factor predictive of PAL.
Conclusions
UNASSIGNED
A dense fissure is not a contraindication for uniportal thoracoscopic lobectomy using the fissureless technique, which is thus safe.
Identifiants
pubmed: 36647473
doi: 10.21037/jtd-22-1073
pii: jtd-14-12-4650
pmc: PMC9840050
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4650-4659Informations de copyright
2022 Journal of Thoracic Disease. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-1073/coif). HI served as unpaid editorial board member of Journal of Thoracic Disease from August 2022 to July 2024. The other authors have no conflict of interest to declare.
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