Complete video-assisted thoracoscopic surgery (VATS) bronchial sleeve lobectomy

Background: To explore the effectiveness of video-assisted thoracoscopic surgery (VATS) bronchial sleeve resection and reconstruction. Methods: The clinical data of patients who had received VATS bronchial sleeve lobectomy in our center from January 2008 to February 2015 were retrospectively analyzed. Results: Totally 118 patients (105 men and 13 women) received the VATS bronchial sleeve lobectomy. The procedures included sleeve resection of right upper lobe (n=59), right middle lobe (n=7), right lower lobe (n=8), left upper lobe (n=34), and left lower lobe (n=10). The lesions were confirmed to be squamous cell carcinoma (n=68), adenocarcinoma (n=16), mucoepidermoid carcinoma (n=8), adenosquamous carcinoma (n=7), large cell carcinoma (n=1), carcinoids (n=5), and others (n=13; including small cell carcinoma, pleomorphic carcinoma, and inflammatory myofibroblastic tumor). Operations lasted 118-223 min [mean +/- standard deviations (SD): 124.00 +/- 31.75 min]. The length of removed bronchus was 1.50-2.00 cm (mean +/- SD: 1.75 +/- 0.26 cm). The duration of bronchial anastomosis (from the first puncture to the completion of knotting) was 15-42 min (mean +/- SD: 30.20 +/- 7.97 min). The number of dissected lymph node stations (at least three mediastinal lymph node stations, including station 7) was 5-9 stations (mean +/- SD: 6.50 +/- 1.18 min). The number of dissected lymph nodes was 10-46 (mean +/- SD: 26.00 +/- 10.48). The intraoperative blood loss was 20-400 mL (mean +/- SD: 71.00 +/- 43.95 mL), and no blood transfusion was performed. All patients were observed in intensive care unit (ICU) for 1 day. Postoperative drainage was performed for 3-8 days (mean +/- SD: 5.00 +/- 1.49 days). Postoperative hospital stay was 3-8 days (mean +/- SD: 5.10 +/- 2.07 days). Conclusions: VATS bronchial sleeve resection and reconstruction is a safe and feasible technique.