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Ann Thorac Surg 2012;93:1033-1040. doi:10.1016/j.athoracsur.2012.01.012
© 2012 The Society of Thoracic Surgeons
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Original Articles: General Thoracic

Thoracoscopic Lobectomy and Segmentectomy for Infectious Lung Disease

John D. Mitchell, MDa,b,*, Jessica A. Yu, MDa, Amy Bishop, BAa, Michael J. Weyant, MDa,b, Marvin Pomerantz, MDa,b

a Section of General Thoracic Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado
b Center for the Surgical Treatment of Lung Infections, Division of Cardiothoracic Surgery, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado

Accepted for publication January 6, 2012.

* Address correspondence to Dr Mitchell, Division of Cardiothoracic Surgery, C-310, University of Colorado Anschutz Medical Campus, Academic Office 1, Room 6607, 12631 E 17th Ave, Aurora, CO 80045 (Email: john.mitchell{at}ucdenver.edu).

Presented at the Forty-seventh Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2011.

Background: The potential benefits of thoracoscopic lobectomy and segmentectomy for early stage non–small cell lung cancer have been well documented in the literature. However, little is known about the use of these techniques in patients requiring resection for infectious or inflammatory lung disease.

Methods: Using a prospectively collected database, we performed a retrospective review of consecutive operations from July 2004 to June 2010. All patients who underwent elective thoracoscopic lobectomy or segmentectomy for focal bronchiectasis or cavitary lung disease associated with active pulmonary infection were included.

Results: In all, 212 resections were performed in 171 patients. The average age was 59 years (range, 26 to 82 years). Patients were predominately white (93%) and female (93%). Indications for surgery included recurrent active infection, hemoptysis, or antibiotic intolerance associated with focal bronchiectasis (86%), cavitary disease (7%), or both (7%). Operations included 126 lobectomies, 73 segmentectomies, 10 lobe plus segmental resections, and 3 bilobectomies. Conversion to thoracotomy occurred in 10 patients. The operative mortality rate was zero. Complications occurred in 9%, consisting largely of prolonged air leak and atrial fibrillation. The mean hospital length of stay was 3.7 days.

Conclusions: Thoracoscopic lobectomy and segmentectomy for individuals with infectious lung disease can be accomplished safely with minimal morbidity and mortality. These techniques may provide the optimal surgical approach for patients with focal bronchiectasis or cavitary lung disease requiring resection.






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