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find Author "SUN Fenghua" 1 results
  • Complete Video-assisted Thoracoscopic Surgery Lobectomy for the Treatment of Bronchiectasis

    Abstract: Objective To compare clinical outcomes of complete video-assisted thoracoscopic surgery (cVATS) lobectomy with routine thoracotomy lobectomy for the treatment of bronchiectasis, and evaluate the feasibility, safety and specific considerations of cVATS lobectomy for the treatment of bronchiectasis. Methods We retrospectively analyzed the clinical data of 115 patients who underwent lobectomy for the treatment of bronchiectasis in Beijing Chaoyang Hospital from May 2009 to January 2012. According to the way of operation, these patients were divided into two groups (cVATS group and thoracotomy group). In the thoracotomy group, there were 62 patients (28 males and 34 females with an age of 46.2±11.9 years) who underwent routine thoracotomy lobectomy. In the cVATS group, there were 53 patients (19 males and 34 females with an age of 45.7±12.2 years) who underwent cVATS lobectomy. Operation time, intra-operative blood loss, postoperative thoracic drainage, complications and hospitalization, and cost of hospitalization were compared between the two groups. Results There was no perioperative death in all patients. There was no statistical difference in operation time between the two groups. Intra-operative blood loss of thoracotomy group patients was significantly higher than that of cVATS group patients (228.8±121.7 ml vs. 157.1±123.8 ml, t=2.592, P=0.011). Postoperative thoracic drainage (866.7±439.5 ml vs. 1 805.3±466.7 ml, t=9.003,P=0.000), duration of chest tube drainage (6.6±3.3 d vs. 9.8±4.6 d,t=3.339,P=0.001), and postoperative hospitalization (7.5±2.2 d vs. 11.2±5.4 d, t=3.424,P=0.001) of cVATS group were significantly lower than those of thoracotomy group. The cost of hospitalization of cVATS group was significantly higher than that of thoracotomy group (38 543.6±11 051.8 yuan vs. 30 523.4±10 028.5 yuan,t=3.423, P=0.001). There was no statistical difference in postoperative complications between the two groups (P>0.05). Forty-five patients in cVATS group were followed up for 2 to 14 months. Among them, 42 patients completely had no sputum or haemoptysis and 3 patients still intermittently had some sputum. Conclusion cVATS lobectomy is safe and feasible for the treatment of bronchiectasis. Compared with routine thoracotomy lobectomy, cVATS lobectomy does not increase surgical risk, but can significantly reduce operation injury and length of hospital stay. During cVATS, the lung residual should be handled cautiously especially for patients with nonanatomic pulmonary resection, and the non-single-order operation is recommended.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
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