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
. 2016 Mar;8(Suppl 3):S235-41.
doi: 10.3978/j.issn.2072-1439.2016.02.25.

Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience

Andrei Lyscov  1 , Tatyana Obukhova  1 , Victoria Ryabova  1 , Dmitrii Sekhniaidze  1 , Vladimir Zuiev  1 , Diego Gonzalez-Rivas  1
Affiliations

Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience

Andrei Lyscov et al. J Thorac Dis. 2016 Mar.

Abstract

Background: Video-assisted thoracic surgery (VATS) double-sleeve lobectomy and carinal resections are two of the most complex procedures in thoracic surgery. The uniportal approach provides an advantage for performing these procedures successfully; however, knowledge of the important technical details is required. This study describes the experience of implementing these procedures by Russian specialists.

Methods: Six patients (one woman; mean age, 57.3±3.6 years) who underwent a uniportal VATS double sleeve and carinal resections were consecutively included in this study. A 5- to 6-cm incision was made at the fifth intercostal space on the middle axillary line.

Results: Double sleeve left upper lobectomy was completed in four cases. One case of the right sleeve carinal pneumonectomy and one case of the right sleeve carinal upper lobectomy were completed. The mean operation time was 280±13 minutes. There was no conversion to thoracotomy. The mean postoperative hospital stay was 10.8±0.8 days. There was no postoperative mortality. In one case of double-sleeve lobectomy, postoperative pneumonia developed. The postoperative diagnoses of the four uniportal double-sleeve cases were as follows: T2aN2M0 in one case, T3N1M0 in two cases, and T2aN0M0 in one case. The postoperative diagnoses of the two uniportal totally carinal resections were as follows: T4N0M0 and T3N0M0.

Conclusions: This study results suggest that a uniportal VATS approach might be a feasible option for complex sleeve resections with acceptable postoperative outcomes in the advanced stages of lung cancer. To further evaluate the feasibility, safety, and efficacy of this technique, more experience would be required.

Keywords: Uniportal video-assisted thoracic surgery (uniportal VATS); single-port video-assisted thoracic surgery (single-port VATS); video-assisted thoracic surgery double-sleeve lobectomy (VATS double-sleeve lobectomy); video-assisted thoracic surgery sleeve pneumonectomy (VATS sleeve pneumonectomy).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mediastinal pleura and diaphragmatic nerve resection.
Figure 2
Figure 2
Dividing of the left upper lobe vein by endostapler.
Figure 3
Figure 3
Dividing of the left upper lobe vein by stapler for open surgery.
Figure 4
Figure 4
Dividing of the ligamentum botalli.
Figure 5
Figure 5
En-block resection.
Figure 6
Figure 6
Performing the anterior wall of bronchial anastomosis.
Figure 7
Figure 7
Performing the posterior wall of arterial anastomosis.
Figure 8
Figure 8
Performing the anterior wall of arterial anastomosis.
Figure 9
Figure 9
Initial view of the vena cava superior lesion.
Figure 10
Figure 10
Partial resection of the vena cava superior by endostapler.
Figure 11
Figure 11
Sleeve carinal resection on a double-lumen tube.
Figure 12
Figure 12
Switch to high-frequency ventilation.
Figure 13
Figure 13
Performing the left wall of the trachea-bronchial anastomosis.
Figure 14
Figure 14
Performing the anterior wall of the trachea-bronchial anastomosis.
Figure 15
Figure 15
Trachea-bronchial anastomosis covered by the mediastinal pleura flap.
See this image and copyright information in PMC

References

    1. Huang J, Li J, Qiu Y, et al. Thoracoscopic double sleeve lobectomy in 13 patients: a series report from multi-centers. J Thorac Dis 2015;7:834-42. - PMC - PubMed
    1. Gonzalez-Rivas D, Delgado M, Fieira E, et al. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg 2014;3:E2. - PMC - PubMed
    1. Gonzalez-Rivas D, Fieira E, Delgado M, et al. Uniportal video-assisted thoracoscopic sleeve lobectomy and other complex resections. J Thorac Dis 2014;6:S674-81. - PMC - PubMed
    1. Gonzalez-Rivas D, Yang Y, Stupnik T, et al. Uniportal video-assisted thoracoscopic bronchovascular, tracheal and carinal sleeve resections†. Eur J Cardiothorac Surg 2016;49 Suppl 1:i6-i16. - PubMed
    1. Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg 2013;95:426-32. - PubMed