Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May;7(5):834-42.
doi: 10.3978/j.issn.2072-1439.2015.04.55.

Thoracoscopic double sleeve lobectomy in 13 patients: a series report from multi-centers

Jun Huang  1 , Jingpei Li  1 , Yuan Qiu  1 , Xin Xu  1 , Dmitrii Sekhniaidze  1 , Hanzhang Chen  1 , Diego Gonzalez-Rivas  1 , Jianxing He  1
Affiliations

Thoracoscopic double sleeve lobectomy in 13 patients: a series report from multi-centers

Jun Huang et al. J Thorac Dis. 2015 May.

Abstract

Background: This study aims to explore the feasibility and safety of video-assisted thoracic surgery (VATS) double sleeve lobectomy in patients with non-small lung cell cancer (NSCLC).

Methods: Between June 2012 and August 2014, 13 NSCLC patients underwent thoracoscopic double sleeve lobectomy and mediastinal lymphadenectomy at three institutions. A retrospective analysis of clinical characteristics, operative data, postoperative events and follow-up was performed.

Results: Thirteen NSCLC patients (median age, 60 years; range, 43-67 years) underwent thoracoscopic double sleeve lobectomy. There were no conversions to thoracotomy. Left upper lobectomy was most frequently performed (eleven patients). Median operative time was 263 minutes (range, 218-330 minutes), and median blood loss was 224 mL (range, 60-400 mL). The learning curve revealed reductions in both operative times and blood loss of ten cases from one center. Median data were duration of blocking pulmonary artery (PA) 72 minutes (range, 44-143 minutes), resected lymph nodes 24 (range, 10-46), stations of retrieved lymph nodes 6 (range, 5-9), thoracic drainage 1,042 mL (range, 500-1,700 mL), duration of thoracic drainage 5 days (range, 3-8 days), postoperative hospital stay 10 days (range, 7-20 days), and ICU stay 1 day (range, 1-2 days). One patient (1/13, 7.70%) suffered from pneumonia after surgery. There were no deaths at 30 days. Median duration of follow-up was 6 months (range, 1-26 months). And no local recurrences or distant metastasis were reported.

Conclusions: Thoracoscopic double sleeve lobectomy is a technically challenging, but feasible procedure for NSCLC patients and it should be restricted to skilled VATS surgeons.

Keywords: Non-small lung cell cancer (NSCLC); learning curve; sleeve lobectomy; video-assisted thoracic surgery (VATS).

PubMed Disclaimer

Figures

Figure 1
Figure 1
Surgical technique of thoracoscopic double sleeve lobectomy. (A) Transecting the main bronchus; (B) sleeve resecting the blocked PA; (C) sleeve reconstructing the blocked PA; (D) completed vascular reconstruction and starting sleeve bronchial reconstruction; (E) sleeve reconstructing the bronchus; (F) over view of double sleeve reconstruction. PA, pulmonary artery.
Figure 2
Figure 2
Method A: ports design of thoracoscopic double sleeve lobectomy.
Figure 3
Figure 3
Method B: ports design of thoracoscopic double sleeve lobectomy.
Figure 4
Figure 4
Method C: ports design of thoracoscopic double sleeve lobectomy.
Figure 5
Figure 5
Method D: ports design of thoracoscopic double sleeve lobectomy.
Figure 6
Figure 6
Promising reductions in operative times and blood loss of ten cases from one center
See this image and copyright information in PMC

References

    1. Cao C, Zhu ZH, Yan TD, et al. Video-assisted thoracic surgery versus open thoracotomy for non-small-cell lung cancer: a propensity score analysis based on a multi-institutional registry. Eur J Cardiothorac Surg 2013;44:849-54. - PubMed
    1. Hennon M, Sahai RK, Yendamuri S, et al. Safety of thoracoscopic lobectomy in locally advanced lung cancer. Ann Surg Oncol 2011;18:3732-6. - PubMed
    1. Ikeda N, Saji H, Hagiwara M, et al. Recent advances in video-assisted thoracoscopic surgery for lung cancer. Asian J Endosc Surg 2013;6:9-13. - PubMed
    1. Ma Z, Dong A, Fan J, et al. Does sleeve lobectomy concomitant with or without pulmonary artery reconstruction (double sleeve) have favorable results for non-small cell lung cancer compared with pneumonectomy? A meta-analysis. Eur J Cardiothorac Surg 2007;32:20-8. - PubMed
    1. Santambrogio L, Cioffi U, De Simone M, et al. Video-assisted sleeve lobectomy for mucoepidermoid carcinoma of the left lower lobar bronchus: a case report. Chest 2002;121:635-6. - PubMed