Video–assisted thoracoscopic lobectomies in a phthisiatric, nonspecific and oncological pulmonary affection

Keywords: lobectomy; VATS partial pulmonary resection; video–assisted resection

Abstract

Objective. To share own experience of performance of video–assisted thoracoscopic (VATS) lobectomies in patients with phthisiatric, nonspecific and oncological pulmonary damage in 2014 – 2019 yrs.

Materials and methods. Through last 5 years we performed 72 VATS resections of the pulmonary lobe, including 30 (41.7%) typical VATS lower lobectomies with separate surgical processing of elements of the lobe. In 1 (1.4%) patient conversion to thoracotomy was performed when a hemorrhage have occurred. Among the patients women prevailed – 46 (63.9%). The patient’s age was between 17 and 85 years, (39.2 ± 6.2) years at average.

Operative intervention was done for pulmonary tuberculosis in 57 (79.2%) patients, for cancer – in 7 (9.7%), inborn pulmonary hypoplasia – in 2 (2.8%), arterio–venous malformation – in 1 (1.4%), hamartochondroma of big dimensions – in 2 (2.8%), bronchoechtatic disease – in 2 (2.8%), intralobar sequestration – in 1 (1.4%) patient.

Results. Intraoperative complications were diagnosed in 3 (4.2%) patients. Total morbidity have occurred in 12 (16.7%) patients. Total efficacy of performance of the VATS lobectomy have constituted 98.6%, median duration of resections – (185.1 ± 72.2) min, average blood loss volume – (154.1 ± 73.8) ml, median duration of treatment in postoperative period – (29.2 ± 14.1) days, rate of conversion to wide thoracotomy – 1,4%.

Conclusion. VATS lobectomy constitutes an effective method of surgical treatment in patients, who need performance of thoracic operations, including phthisiatric and oncological. This kind of operation is perspective, miniinvasive, guarantees anatomic preparation of elements of the pulmonary lobe radix, and it may be regarded as alternative to open lobectomy. Pronounced fibrosis of pulmonary radix due to durable inflammatory process and prolonged medicinal treatment, as well as the cost of endoscopic instruments, preclude wide application of this method.

Author Biographies

M. S. Opanasenko, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Opanasenko Mykola Stepanovych - MD, DSci(med), Professor,
Head of the Department of Thoracic Surgery and Invasive Diagnostic Methods,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
tel: +380672718511
E-mail: opanasenko@ifp.kiev.ua
ORCID: 0000-0003-4071-2005

S. M. Shalahai, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Shalahai Serhii Mykhailovych – MD, PhD, Researcher,
Department of Thoracic Surgery and Invasive Diagnostic Methods,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
tel: 0938565739
E-mail: Serdok08@gmail.com
ORCID: 0000-0001-8265-9201

O. V. Tereshkovych, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Tereshkovych Olexandr Volodymyrovych - MD, PhD, Researcher,
Department of Thoracic Surgery and Invasive Diagnostic Methods,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
tel: +380504457012
e-mail: tereshkovich@ukr.net
ORCID: 0000-0002-7202-295X

B. M. Konik, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Konik Bohdan Mykolaiovych- MD, PhD, Researcher,
Head of the department of surgical treatment of tuberculosis and non-specific diseases of the lungs complicated by purulent-septic infections,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
ORCID: 0000-0001-9226-0173

L. I. Levanda, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Levanda Larysa Ivanivna – MD
Head of the Department of Anesthesiology,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
ORCID: 0000-0002-6302-2296

V. B. Bychkovskyi, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Bychkovskyi Viktor Borysovych – MD, PhD,
Department of bronchology,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
ORCID 0000-0001-9777-7569

M. Yu. Shamray, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Shamray Maksym Yuriyovych – MD, anesthetist,
department of anesthesiology,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
ORCID: 0000-0002-3997-8204

M. I. Kalenichenko, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Kalenichenko Maksym Ivanovich - MD, PhD,
Department of Thoracic Surgery and Invasive Methods of Diagnostics,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
ORCID: 0000-0003-0417-8191

V. I. Lysenko, Yanovskyi National Institute of Phthisiatry and Pulmonology, Kyiv, Ukraine

Lysenko Volodymyr Ihorovych – MD, Researcher,
Department of Thoracic Surgery and Invasive Diagnostic Methods,
Yanovsky National Institute of Phthisiology and Pulmonology
Kyiv, Ukraine, Amosova st.,10
ORCID: 0000-0001-9421-9887

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Published
2019-09-28
How to Cite
Opanasenko, M. S., Shalahai, S. M., Tereshkovych, O. V., Konik, B. M., Levanda, L. I., Bychkovskyi, V. B., Shamray, M. Y., Kalenichenko, M. I., & Lysenko, V. I. (2019). Video–assisted thoracoscopic lobectomies in a phthisiatric, nonspecific and oncological pulmonary affection. Klinicheskaia Khirurgiia, 86(9), 3-7. https://doi.org/10.26779/2522-1396.2019.09.03
Section
General Problems of Surgery