Technique for delivering large tumors in video-assisted thoracoscopic lobectomy
| العنوان: | Technique for delivering large tumors in video-assisted thoracoscopic lobectomy |
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| المؤلفون: | Arun Nair, Sohini Paul, Jesse Lee, Surbhi Chawla, Kanhua Yin, Alan D. L. Sihoe |
| المصدر: | Asian Cardiovascular and Thoracic Annals. 22:319-328 |
| بيانات النشر: | SAGE Publications, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Time Factors, medicine.medical_treatment, Ribs, Pneumonectomy, Port (medical), Blood loss, medicine, Humans, Video assisted, Lung cancer, Aged, Retrospective Studies, Aged, 80 and over, Pain, Postoperative, Rib cage, Thoracic Surgery, Video-Assisted, business.industry, General Medicine, Length of Stay, Middle Aged, medicine.disease, Tumor Burden, Surgery, Treatment Outcome, medicine.anatomical_structure, Thoracotomy, Cardiothoracic surgery, Feasibility Studies, Female, Intercostal space, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background The optimal technique for delivering large tumors during video-assisted thoracoscopic lobectomy remains uncertain. Methods In 258 patients receiving video-assisted thoracoscopic lobectomy for lung cancer, techniques for delivering the resected lobe included complete video-assisted thoracoscopic lobectomy without rib spreading ( n = 206, 80%), resection of a short rib segment ( n = 9, 3%), brief rib spreading ( n = 12, 5%), and conversion to a minithoracotomy ( n = 21, 8%). In 10 (4%) patients, a novel anterior rib cutting technique was used: one rib at the utility port was cut near its anterior end to widen the intercostal space without forcible rib spreading for lobe delivery. Results There was no mortality or major morbidity using the anterior rib cutting technique, and it delivered tumors of a larger mean diameter than complete video-assisted thoracoscopic lobectomy (5.4 ± 3.4 vs. 2.3 ± 1.4 cm, p = 0.017) whilst yielding a similar mean operation time and blood loss to the other non-complete video-assisted thoracoscopic lobectomy techniques. The anterior rib cutting technique gave similar postoperative patient pain scores and analgesic use to complete video-assisted thoracoscopic lobectomy, and shorter mean hospital stay than the other non-complete video-assisted thoracoscopic lobectomy techniques (5.6 ± 2.8 vs. 10.0 ± 7.1 days, p = 0.003). Conclusions In video-assisted thoracoscopic lobectomy, the anterior rib cutting technique is a safe and feasible procedure for delivering large tumors, causing no more pain than complete video-assisted thoracoscopic lobectomy, and allowing faster recovery than other non-complete video-assisted thoracoscopic lobectomy techniques. |
| تدمد: | 1816-5370 0218-4923 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b6dd3e24e302f9910d835042186535b3Test https://doi.org/10.1177/0218492313503641Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....b6dd3e24e302f9910d835042186535b3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18165370 02184923 |
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