TY  - JOUR
UR  - http://publicatio.bibl.u-szeged.hu/11813/
Y1  - 2016///
EP  - 104
SN  - 0025-0295
TI  - Minimálisan invazív tüd?lebeny-eltávolítás eredményei osztályunk ötéves anyagában [Results of the video-assisted thoracic surgery lobectomy at our department in the last five-year periode]
VL  - 69
JF  - MAGYAR SEBÉSZET
IS  - 3
N1  - FELTÖLT?: Bernátskyné Babus Csilla - csbabus@ek.szte.hu
SP  - 100
ID  - publicatio11813
AV  - restricted
N2  - 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.
A1  -  Furák József
A1  -  Pécsy Balázs
A1  -  Ottlakán Aurél
A1  -  Németh Tibor
A1  -  Géczi Tibor
A1  -  Tiszlavicz László
A1  -  Lázár György ifj.
ER  -