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Ann Thorac Surg 2008;85:S729-S732. doi:10.1016/j.athoracsur.2007.12.001
© 2008 The Society of Thoracic Surgeons
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Ali Mahtabifard
Clark B. Fuller
Robert J. McKenna, Jr
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Right arrow Minimally invasive surgery

Supplement: The Minimally Invasive Thoracic Surgery Summit

Video-Assisted Thoracic Surgery Sleeve Lobectomy: A Case Series

Ali Mahtabifard, MD*, Clark B. Fuller, MD, Robert J. McKenna, Jr, MD

Department of Thoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, California

* Address correspondence to Dr Mahtabifard, Cedars-Sinai Medical Center, 8635 W Third St, Ste 975W, Los Angeles, CA 90048 (Email: mahtabifarda{at}cshs.org).

Presented at the Minimally Invasive Thoracic Surgery Summit, New York, NY, June 8–9, 2007.

Background: As thoracic surgery moves towards more minimally invasive procedures, such as video-assisted thoracic surgery (VATS) lobectomy, conversion from a VATS to open thoracotomy has been required for a sleeve resection. This article reports a large experience of VATS sleeve lobectomy.

Methods: We reviewed our thoracic surgery database of more than 1500 VATS lobectomies for VATS sleeve resections. Preoperative, operative, and perioperative outcome variables, including morbidity and mortality were examined.

Results: Identified were 13 patients (median age, 59 years; range, 16 to 82 years) who underwent VATS sleeve lobectomy. There were no conversions to thoracotomy. Diagnoses included non-small cell lung cancer in 8 patients, typical carcinoid in 4, and metastatic sarcoma in 1 patient. Median tumor size was 2.1 cm (range, 0 to 6.6 cm). Median data were operative time, 167 minutes (range, 90 to 300 minutes); blood loss, 250 mL (range, 75 to 800 mL); chest tube drainage, 692 mL (range, 459 to 1590 mL); and chest tube duration, 3 days (range, 2 to 6 days). Median intensive care unit stay was 0 days (range, 0 to 4 days), and median hospital stay was 3 days (range, 2 to 8 days). No complications occurred in 9 patients (69%). Morbidity in the remaining 4 patients included 1 patient each with atrial fibrillation, anastomotic stricture, reintubation, and bronchial tear requiring repair. There were no deaths at 30 days.

Conclusions: In experienced centers, VATS sleeve lobectomy is possible with acceptable morbidity and mortality as well as short length of stay.




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