Single-center experience of simultaneous bilateral uni-portal video-assisted thoracoscopic surgery for multiple ground-glass opacities
Open Access
- 23 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Cardiothoracic Surgery
- Vol. 15 (1), 1-7
- https://doi.org/10.1186/s13019-020-01107-0
Abstract
Background There is an increasing incidence rate of ground-glass opacity (GGO), especially for multiple GGOs (>= 2). Whether it is safe and feasible to have bilateral simultaneous surgical resection remains unknown. The purpose of this study is to summarize the experience of surgical resection of patients with multiple GGOs in our Hospital in recent years, and to discuss the above questions. Methods Clinical datas of patients who underwent one-stage bilateral uni-portal VATS resections of multiple pulmonary ground glass opacities and had routine pathological examination were collected from May 2016 to May 2019 in our hospital. Results A total of 34 patients underwent simultaneous bilateral surgical resection of multiple GGO lesions, 28 were women,6 were men, the average age of total patients was 57.9 +/- 6.7 years. All patients underwent bilateral uni-portal video-assisted thoracoscopic surgery (Uni-portal VATS), the average intraoperative blood loss was 100.9 +/- 67.7 ml, the average operation time was 140 +/- 74.8 min, the average thoracic drainage time was 2.8 +/- 3.1 days, and the average postoperative hospital stay was 4.2 +/- 4.3 days. Postoperative complications including: 2 cases of infection, 3 cases of atrial fibrillation, and 5 cases of persistent air leakage for more than 3 days. All of them improved after treatment, and there were no serious complications and deaths in perioperative period. A total of 76 GGO lesions were resected, with a total malignancy rate of 81.6%, including 40 were pure GGO, of which 28 were malignant (70%), and the average diameter of them were 9.6 +/- 3.8 mm; 36 were mixed GGO, of which 34 were malignant (94.4%), the average diameter of them were 15.6 +/- 6.6 mm.Mean postoperative follow-up was 28.4 (range, 3-39) months. There was neither recurrence nor deaths at final follow-up. Conclusion The malignancy rate of multiple GGOs is high. Therefore, when the lung function is allowed,one-stage bilateral uni-portal VATS can be considered. According to experience of main surgeon and the frozen biopsy, either sub-lobar resection or lobectomy was acceptable. The risk of postoperative complications and the prognosis were optimal.This publication has 21 references indexed in Scilit:
- Clinical analysis of 56 cases of simultaneous bilateral video-assisted thoracoscopic surgery for bilateral synchronous multiple primary lung adenocarcinomaJournal of Thoracic Disease, 2018
- Favorable prognosis and high discrepancy of genetic features in surgical patients with multiple primary lung cancersThe Journal of Thoracic and Cardiovascular Surgery, 2018
- The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Application of TNM Staging Rules to Lung Cancer Presenting as Multiple Nodules with Ground Glass or Lepidic Features or a Pneumonic Type of Involvement in the Forthcoming Eighth Edition of the TNM ClassificationJournal of Thoracic Oncology, 2016
- Survival of a surgical series of lung cancer patients with synchronous multiple ground-glass opacities, and the management of their residual lesionsLung Cancer, 2015
- Pure Ground-Glass Opacity Neoplastic Lung Nodules: Histopathology, Imaging, and ManagementAmerican Journal of Roentgenology, 2014
- Recommendations for the Management of Subsolid Pulmonary Nodules Detected at CT: A Statement from the Fleischner SocietyRadiology, 2013
- Ground-glass Opacity NodulesJournal of Thoracic Imaging, 2011
- International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung AdenocarcinomaJournal of Thoracic Oncology, 2011
- Nodular Ground-Glass Opacity at Thin-Section CT: Histologic Correlation and Evaluation of Change at Follow-upRadioGraphics, 2007
- Surgical Treatments for Multiple Primary Adenocarcinoma of the LungThe Annals of Thoracic Surgery, 2004