Thoracoscopic lobectomy for lung cancer with a largely fused fissure

Hiroaki Nomori, Takashi Ohtsuka, Hirotoshi Horio, Tsuguo Naruke, Keiichi Suemasu

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: While isolating the pulmonary arterial branches within the fissure is a crucial step in lobectomy, a largely fused fissure usually hinders its achievement, making lobectomy with video-assisted thoracoscopic surgery (VATS) difficult to achieve. For VATS lobectomy in lung cancer patients with a largely fused fissure, we have conducted an unusual approach for each lobe, and the surgical results were compared between patients with and without a fused fissure. Methods: Since 1999, we have conducted VATS lobectomies in 77 patients. Of these, 10 had largely fused fissures that needed an unusual surgical approach for dividing the pulmonary arterial branches. The other 67 patients had separated fissures that allowed the isolation and division of the arterial branches within it. While the surgical approach used for the patients with largely fused fissures differed in each lobe, most often the lobar bronchus was divided before pulmonary arterial branches within the fissure were divided, with the fused fissure being divided last. Results: There were no significant differences in age, lobectomy site, or tumor stage between the patients with fused fissures and those with separated fissures. The surgical data showed no significant differences between the two groups in operating time, blood loss, duration of chest tube drainage, and hospital stay after surgery. However, the patients with fused fissures required more staples to close the incision than did those with a separated fissure (mean number of staples, 7.7 vs 5.7; p < 0.001). There was no postoperative mortality or morbidity, including prolonged air leakage, in the patients with fused fissures. Conclusion: Although the performance of VATS lobectomy for patients with largely fused fissures is more costly, it is feasible and safe. A largely fused fissure is not a limiting factor for the performance of VATS lobectomy.

Original languageEnglish
Pages (from-to)619-622
Number of pages4
JournalChest
Volume123
Issue number2
DOIs
Publication statusPublished - 2003 Feb 1
Externally publishedYes

Fingerprint

Lung Neoplasms
Video-Assisted Thoracic Surgery
Lung
Chest Tubes
Bronchi
Drainage
Length of Stay
Air
Morbidity
Mortality
Neoplasms

Keywords

  • Fused fissure
  • Lobectomy
  • Lung cancer
  • Thoracoscopy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Nomori, H., Ohtsuka, T., Horio, H., Naruke, T., & Suemasu, K. (2003). Thoracoscopic lobectomy for lung cancer with a largely fused fissure. Chest, 123(2), 619-622. https://doi.org/10.1378/chest.123.2.619

Thoracoscopic lobectomy for lung cancer with a largely fused fissure. / Nomori, Hiroaki; Ohtsuka, Takashi; Horio, Hirotoshi; Naruke, Tsuguo; Suemasu, Keiichi.

In: Chest, Vol. 123, No. 2, 01.02.2003, p. 619-622.

Research output: Contribution to journalArticle

Nomori, H, Ohtsuka, T, Horio, H, Naruke, T & Suemasu, K 2003, 'Thoracoscopic lobectomy for lung cancer with a largely fused fissure', Chest, vol. 123, no. 2, pp. 619-622. https://doi.org/10.1378/chest.123.2.619
Nomori H, Ohtsuka T, Horio H, Naruke T, Suemasu K. Thoracoscopic lobectomy for lung cancer with a largely fused fissure. Chest. 2003 Feb 1;123(2):619-622. https://doi.org/10.1378/chest.123.2.619
Nomori, Hiroaki ; Ohtsuka, Takashi ; Horio, Hirotoshi ; Naruke, Tsuguo ; Suemasu, Keiichi. / Thoracoscopic lobectomy for lung cancer with a largely fused fissure. In: Chest. 2003 ; Vol. 123, No. 2. pp. 619-622.
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