[Results of the video-assisted thoracic surgery lobectomy at our department in the last five-year periode]. / Minimálisan invazív tüdolebeny-eltávolítás eredményei osztályunk ötéves anyagában.

ABSTRACT

OBJECTIVES: Herein we present the results of lobectomies performed with minimally invasive approach (video-assisted thoracic surgery - VATS) at our department during a period of five years. METHODS: Between 1 January 2011 and 31 December 2015, 197 lobectomies (malignant lesions 176 cases, benign lesions 21 cases) were performed by three thoracic surgeons and one resident. Demographical data are as follows 119 female/78 male, mean age 62.4 years (range 41-82 years). In 2011 three VATS lobectomies were performed, equaling 2.2 % of all lobectomies in that year. During the upcomig years the number of VATS lobectomies were as follows 2012 7 (7.3%), 2013 13 (12%), 2014 59 (34.5%) and 2015 119 (68.5%). In 153 cases multiportal (78%) and in 44 cases uniportal (22%) anterior approach was performed. The resected lobes showed the following distribution right upper 85, mid lobe 5, right lower 28, left upper 44, left lower 34, upper bilobectomy 1. In two cases sleeve lobectomy was performed. In 8 cases (4%) conversion to thoracotomy was needed and among the 46 uniportal procedures, 5 cases needed to be expanded into biportal approach (11%). RESULTS: During the study period, no intraoperative, or perioperative mortality occured. Mean operative time was 123 minutes (range 60-135 minutes) and mean time of chest drainage was 4.3 days (range 1-27 days). Air leakage lasting more than 7 days was present in 11.7%. Reoperation was needed in 4 cases (2%), in two cases due to bleeding, and in two cases because of expansive difficulties due to extended subcutaneous emphysema. Among the 176 VATS lobectomies performed due to malignant lesions, 169 lung cancers and 7 metastases were removed. The distribution according to the stage and histology of lung cancers was as follows IA 100 cases, IB 28 cases, IIA 17 cases, IIB 3 cases, IIIA 16 cases, IIIB 1 case, and IV 4 cases; adenocarcinoma 128 cases, squamous cell carcinoma 26 cases, large cell carcinoma 3 cases, small cell lung cancer 1 case, typical carcinoid 10 cases, and atypical carcinoid 1 case. CONCLUSIONS: Over the years VATS lobectomy became a rutin procedure at our institution. Nowadays more than two-thirds of lobectomies are performed with minimally invasive technique. Taking the learning curve of the four thoracic surgeons into consideration, our results correlate with international data.