Staged Bilateral Single-port Thoracoscopic Lung Volume Reduction Surgery: A Clinical Analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 ZHANGMiao , PANXue-feng , ZHANGHui

Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou 221009 Jiangshu, P. R. China;

Corresponding author：

ZHANGMiao, Email: zhangpumc@163.com

Keywords：

Chronic obstructive pulmonary emphysema (COPE); Single-port thoracoscopy; Lung volume reduction surgery (LVRS)

DOI：

10.7507/1007-4848.20160007

Video：

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Objective To investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for the patients with chronic obstructive pulmonary emphysema (COPE). Methods We retrospectively analyzed clinical data of eleven male patients with bilateral COPE and bullae in Xuzhou Central Hospital Affiliated to Southeast University from January 2013 through June 2014. All the patients underwent staged bilateral single-port thoracoscopic LVRS with their age of 60.27± 12.11 years. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin. Besides, the pulmonary function, blood gas assay, 6-minute walk distance (6-MWD), and life quality evaluated by short form 36 Health survey questionnaire (SF-36) were recorded before and after LVRS respectively. Results All the patients survived after surgery. Chest tube drainage time was 9.09± 1.31 days. Postoperative hospital stay was 15.73± 2.75 days. There were 5 patients with persistent air leakage and 7 patients with pulmonary infection who were cured finally. The pulmonary function, arterial partial pressure of oxygen(PaO₂), 6-MWD and life quality after unilateral or bilateral LVRS improved than those before surgery in postoperative 3 months. However, there was no statistical difference in outcomes between unilateral and bilateral LVRS patients. Conclusion Staged bilateral single-port thoracoscopic LVRS could improve short-term life quality of patients with COPE.

Citation： ZHANGMiao, PANXue-feng, ZHANGHui. Staged Bilateral Single-port Thoracoscopic Lung Volume Reduction Surgery: A Clinical Analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(1): 25-28. doi: 10.7507/1007-4848.20160007 Copy

1.	Kaplan RM, Sun Q, Naunheim KS, et al. Long-term follow-up of high-risk patients in the national emphysema treatment trial. Ann Thorac Surg, 2014, 98(5): 1782-1789.
2.	Oey IF, Morgan MD, Spyt TJ, et al. Staged bilateral lung volume reduction surgery——the benefits of a patient-led strategy. Eur J Cardiothorac Surg, 2010, 37(4): 846-852.
3.	Ginsburg ME, Thomashow BM, Yip CK, et al. Lung volume reduction surgery using the NETT selection criteria. Ann Thorac Surg, 2011, 91(5):1556-1561.
4.	周渝斌, 刘伦旭, 喻鹏铭, 等.胸腔镜肺叶切除术后心肺功能的快速康复.中国胸心血管外科临床杂志, 2013, 20(2): 168-171.
5.	Ng CS, Rocco G, Wong RH, et al. Uniportal and single-incision video-assisted thoracic surgery: the state of the art. Interact Cardiovasc Thorac Surg, 2014, 19(4): 661-666.
6.	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(2): E2.
7.	黄伟, 邓波, 王如文, 等.肺减容术对肺气肿治疗效果的评价.中华胸心血管外科杂志, 2012, 28(5): 312-314.
8.	Clark SJ, Zoumot Z, Bamsey O, et al. Surgical approaches for lung volume reduction in emphysema. Clin Med, 2014, 14(2): 122-127.
9.	秦卫, 张爱平, 郑琳, 等.电视胸腔镜双侧肺减容术21例.中国胸心血管外科临床杂志, 2012, 19(4): 444-446.
10.	Armstrong HF, Dussault NE, Thirapatarapong W, et al. Ventilatory efficiency before and after lung volume reduction surgery. Respir Care, 2015, 60(1): 63-71.
11.	车国卫, 刘伦旭.单孔电视胸腔镜手术临床应用的现状与进展.中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
12.	刘成武, 刘伦旭.单孔胸腔镜:微创肺癌切除的再次升华.中国肺癌杂志, 2014, 17(7): 527-530.
13.	Rathinam S, Naidu BV, Nanjaiah P, et al. BioGlue and Peri-strips in lung volume reduction surgery: pilot randomised controlled trial. J Cardiothorac Surg, 2009, 4: 37.
14.	How CH, Tsai TM, Kuo SW, et al. Chemical pleurodesis for prolonged postoperative air leak in primary spontaneous pneumothorax. J Formos Med Assoc, 2014, 113(5): 284-290.
15.	支修益.胸外科围手术期气道管理专家共识(2012年版).中国胸心血管外科临床杂志, 2013, 20(3): 251-255.
16.	Mei J, Liu LX, Tang ML, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Dis, 2014, 6(9): 1200-1208.
17.	Beckers F, Lange N, Koryllos A, et al. Unilateral Lobe resection by video-assisted thoracoscopy leads to the most optimal functional improvement in severe emphysema. Thorac Cardiovasc Surg, 2014 Dec 23.[Epub ahead of print].
18.	Iftikhar IH, McGuire FR, Musani AI. Efficacy of bronchoscopic lung volume reduction: a meta-analysis. Int J Chron Obstruct Pulmon Dis, 2014, 9: 481-491.
19.	陈颖, 陈静瑜, 王振兴.肺移植与肺减容术治疗终末期肺气肿的疗效分析.中国胸心血管外科临床杂志, 2012, 19(2): 141-144.
20.	Trotter MA, Hopkins PM. Advanced therapies for COPD-What's on the horizon? Progress in lung volume reduction and lung transplantation. J Thorac Dis, 2014, 6(11): 1640-1653.
21.	Shah PL, Herth FJ. Current status of bronchoscopic lung volume reduction with endobronchial valves. Thorax, 2014, 69(3): 280-286.

1. Kaplan RM, Sun Q, Naunheim KS, et al. Long-term follow-up of high-risk patients in the national emphysema treatment trial. Ann Thorac Surg, 2014, 98(5): 1782-1789.
2. Oey IF, Morgan MD, Spyt TJ, et al. Staged bilateral lung volume reduction surgery——the benefits of a patient-led strategy. Eur J Cardiothorac Surg, 2010, 37(4): 846-852.
3. Ginsburg ME, Thomashow BM, Yip CK, et al. Lung volume reduction surgery using the NETT selection criteria. Ann Thorac Surg, 2011, 91(5):1556-1561.
4. 周渝斌, 刘伦旭, 喻鹏铭, 等.胸腔镜肺叶切除术后心肺功能的快速康复.中国胸心血管外科临床杂志, 2013, 20(2): 168-171.
5. Ng CS, Rocco G, Wong RH, et al. Uniportal and single-incision video-assisted thoracic surgery: the state of the art. Interact Cardiovasc Thorac Surg, 2014, 19(4): 661-666.
6. 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(2): E2.
7. 黄伟, 邓波, 王如文, 等.肺减容术对肺气肿治疗效果的评价.中华胸心血管外科杂志, 2012, 28(5): 312-314.
8. Clark SJ, Zoumot Z, Bamsey O, et al. Surgical approaches for lung volume reduction in emphysema. Clin Med, 2014, 14(2): 122-127.
9. 秦卫, 张爱平, 郑琳, 等.电视胸腔镜双侧肺减容术21例.中国胸心血管外科临床杂志, 2012, 19(4): 444-446.
10. Armstrong HF, Dussault NE, Thirapatarapong W, et al. Ventilatory efficiency before and after lung volume reduction surgery. Respir Care, 2015, 60(1): 63-71.
11. 车国卫, 刘伦旭.单孔电视胸腔镜手术临床应用的现状与进展.中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
12. 刘成武, 刘伦旭.单孔胸腔镜:微创肺癌切除的再次升华.中国肺癌杂志, 2014, 17(7): 527-530.
13. Rathinam S, Naidu BV, Nanjaiah P, et al. BioGlue and Peri-strips in lung volume reduction surgery: pilot randomised controlled trial. J Cardiothorac Surg, 2009, 4: 37.
14. How CH, Tsai TM, Kuo SW, et al. Chemical pleurodesis for prolonged postoperative air leak in primary spontaneous pneumothorax. J Formos Med Assoc, 2014, 113(5): 284-290.
15. 支修益.胸外科围手术期气道管理专家共识(2012年版).中国胸心血管外科临床杂志, 2013, 20(3): 251-255.
16. Mei J, Liu LX, Tang ML, et al. Airway bacterial colonization in patients with non-small cell lung cancer and the alterations during the perioperative period. J Thorac Dis, 2014, 6(9): 1200-1208.
17. Beckers F, Lange N, Koryllos A, et al. Unilateral Lobe resection by video-assisted thoracoscopy leads to the most optimal functional improvement in severe emphysema. Thorac Cardiovasc Surg, 2014 Dec 23.[Epub ahead of print].
18. Iftikhar IH, McGuire FR, Musani AI. Efficacy of bronchoscopic lung volume reduction: a meta-analysis. Int J Chron Obstruct Pulmon Dis, 2014, 9: 481-491.
19. 陈颖, 陈静瑜, 王振兴.肺移植与肺减容术治疗终末期肺气肿的疗效分析.中国胸心血管外科临床杂志, 2012, 19(2): 141-144.
20. Trotter MA, Hopkins PM. Advanced therapies for COPD-What's on the horizon? Progress in lung volume reduction and lung transplantation. J Thorac Dis, 2014, 6(11): 1640-1653.
21. Shah PL, Herth FJ. Current status of bronchoscopic lung volume reduction with endobronchial valves. Thorax, 2014, 69(3): 280-286.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Staged Bilateral Single-port Thoracoscopic Lung Volume Reduction Surgery: A Clinical Analysis

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