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Q. Pu



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    P3.24 - Poster Session 3 - Supportive Care (ID 160)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P3.24-045 - A first attempt on video-assisted thoracic surgery bronchial sleeve lobectomy concomitant with pulmonary artery reconstruction (double sleeve) for non-small cell lung cancer (ID 2921)

      09:30 - 09:30  |  Author(s): Q. Pu

      • Abstract

      Background
      Bronchial sleeve lobectomy concomitant with pulmonary artery reconstruction (double sleeve) is a reasonable alternative procedure for pneumonectomy in appropriately selected patients with non-small cell lung cancer. However, video-assisted thoracic surgery double sleeve lobectomy is technically more challenging than routine lobectomy, and has never been reported. We aimed to report the first attempt on video-assisted thoracic surgery double sleeve lobectomy for non-small cell lung cancer.

      Methods
      From May 2012 to February 2013, three patients with non-small cell lung cancer of the left hilum directly involving the pulmonary artery were selected for curative resection via the VATS approach. Surgical procedures were performed with four ports for the first patient and three ports for the next two patients. The bronchus and pulmonary artery were reconstructed by end-to-end anastomosis using running Prolene stitches. Low-molecular heparin was subcutaneously administered during the first week after surgery.

      Results
      Surgical duration ranged from 350 to 490 min with blood loss between 30 to 200 ml. The first two patients developed pneumonia after surgery with no mortalities. All the patients were discharged home within 9-14 days after surgery. A total of 17, 12 and 14 lymph nodes were removed, and pathological stage of these three patients were T~2b~N~1~M~0~, T~2a~N~0~M~0~ and T~2b~N~0~M~0~ respectively. The reconstructed bronchus and artery worked well during 3-12 months follow-up.

      Conclusion
      video-assisted thoracic surgery double sleeve lobectomy is technically difficult but feasible. The operation can be successfully finished by skilled thoracoscopic surgeons, but the surgical incisions, procedures, and specific instruments still require further improvement.