Place of robotic surgery in completion lobectomy after anatomical segmentectomy.

Autor:	Piccoli J; Department of Cardiac Surgery, Nancy Regional University Hospital, Institut Lorrain du Cœur et des Vaisseaux. Rue du Morvan, Vandœuvre-lès-Nancy, France., Seitlinger J; Department of Thoracic Surgery, Nancy Regional University Hospital, Institut Lorrain du Cœur et des Vaisseaux. Rue du Morvan, Vandœuvre-lès-Nancy, France., Streit A; Department of Thoracic Surgery, Nancy Regional University Hospital, Institut Lorrain du Cœur et des Vaisseaux. Rue du Morvan, Vandœuvre-lès-Nancy, France., Wollbrett C; Department of Thoracic Surgery, Nancy Regional University Hospital, Institut Lorrain du Cœur et des Vaisseaux. Rue du Morvan, Vandœuvre-lès-Nancy, France., Siat J; Department of Thoracic Surgery, Nancy Regional University Hospital, Institut Lorrain du Cœur et des Vaisseaux. Rue du Morvan, Vandœuvre-lès-Nancy, France., Renaud S; Department of Thoracic Surgery, Nancy Regional University Hospital, Institut Lorrain du Cœur et des Vaisseaux. Rue du Morvan, Vandœuvre-lès-Nancy, France.
Jazyk:	angličtina
Zdroj:	Interdisciplinary cardiovascular and thoracic surgery [Interdiscip Cardiovasc Thorac Surg] 2023 Nov 02; Vol. 37 (5).
DOI:	10.1093/icvts/ivad137
Abstrakt:	Objectives: Although segmentectomy is steadily increasing in early-stage non-small-cell lung cancer, recurrence in the ipsilateral lobe is also increasing. Completion lobectomy (CL) is a challenging procedure that has already been described in a few studies using video-assisted thoracic surgery or thoracotomy. In this study, we aimed to show the feasibility and safety of robot-assisted thoracic surgery in cases of CL. Methods: Among 2073 major resections performed between January 2018 and september 2022 in the Department of Thoracic Surgery at Nancy University Regional Hospital, we retrospectively included patients who underwent CL by robot-assisted thoracic surgery after previous segmentectomy for non-small-cell lung cancer. Data and perioperative results were described and analysed. Results: Seventeen patients underwent CL with a median recurrence time after previous segmentectomy of 18 months [interquartile range (IQR): 12]. Four patients (23.5%) had a pulmonary artery injury that was controlled, and no conversion to open thoracotomy was needed. The operative time was 150 min (IQR: 20), and blood loss was 300 ml (IQR: 150). The median postoperative chest tube duration was 2 days (IQR: 1), and the length of hospital stay was 3 days (IQR: 3), with no postoperative deaths. Conclusions: Completion lobectomy is a challenging procedure due to severe adhesions surrounding vessels, which potentially could cause higher rate of PA bleeding than conventional surgeries. With experienced team and surgeons, CL with robotic surgery may be reported as a safe and feasible procedure. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Databáze:	MEDLINE
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