Zhang S, Zhao Y, Zhou A, Liu H, Zheng M
Department of Thoracic Surgery, Senior Department of Respiratory and Critical Care Medicine, Eighth Medical Center of PLA General Hospital, Beijing 100091, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Jul 20;43(7):1254-1258. doi: 10.12122/j.issn.1673-4254.2023.07.23.
To evaluate the feasibility and safety of one- stage bilateral video-assisted thoracic surgery (VATS) for resection of bilateral multiple pulmonary nodules (BMPNs).
We analyzed the clinical characteristics, pathological features, perioperative outcomes and follow-up data of 41 patients with BMPNs undergoing one-stage bilateral VATS from July, 2011 to August, 2021.
One-stage bilateral VATS was performed uneventfully in 40 of the patients, and conversion to open surgery occurred in 1 case. The surgical approaches included bilateral lobectomy (4.9%), lobar-sublobar resection (36.6%) and sublobar-sublobar resection (58.5%) with a mean operative time of 196.3±54.5 min, a mean blood loss of 224.6±139.5 mL, a mean thoracic drainage duration of 4.7±1.1 days and a mean hospital stay of 14±3.8 days. Pathological examination revealed bilateral primary lung cancer in 15 cases, unilateral primary lung cancer in 21 cases and bilateral benign lesions in 5 cases. A total of 112 pulmonary nodules were resected, including 67 malignant and 45 benign lesions. Postoperative complications included pulmonary infection (5 cases), respiratory failure (2 cases), asthma attack (2 cases), atrial fibrillation (2 cases), and drug-induced liver injury (1 case). No perioperative death occurred in these patients, who had a 1-year survival rate of 97.6%.
With appropriate preoperative screening and perioperative management, one-stage bilateral VATS is feasible and safe for resection of BMPNs.
评估一期双侧电视辅助胸腔镜手术（VATS）切除双侧多发肺结节（BMPNs）的可行性和安全性。
我们分析了2011年7月至2021年8月期间41例行一期双侧VATS的BMPNs患者的临床特征、病理特征、围手术期结果和随访数据。
40例患者一期双侧VATS手术顺利完成，1例中转开胸。手术方式包括双侧肺叶切除术（4.9%）、肺叶-肺段切除术（36.6%）和肺段-肺段切除术（58.5%），平均手术时间为196.3±54.5分钟，平均失血量为224.6±139.5毫升，平均胸腔引流时间为4.7±1.1天，平均住院时间为14±3.8天。病理检查显示双侧原发性肺癌15例，单侧原发性肺癌21例，双侧良性病变5例。共切除112个肺结节，其中恶性病变67个，良性病变45个。术后并发症包括肺部感染（5例）、呼吸衰竭（2例）、哮喘发作（2例）、心房颤动（2例）和药物性肝损伤（1例）。这些患者围手术期无死亡发生，1年生存率为97.6%。
通过适当的术前筛查和围手术期管理，一期双侧VATS切除BMPNs是可行且安全的。
