100 VIDEO-ASSISTED THORACIC SURGICAL SIMULTANEOUSLY STAPLED LOBECTOMIES WITHOUT RIB SPREADING

Background. This study was performed to evaluate and determine the val idity and benefits of video-assisted thoracic surgical simultaneously stapled pulmonary lobectomy without rib spreading. Methods. Between Se ptember 1992 and August 1995, 100 consecutive video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading were performed. Results. Forty-five male and 55 female patients had 24 rig ht upper, 8 right middle, 29 right lower, 24 left upper, 15 left lower lobectomies for 66 adenocarcinomas, 20 squamous cell carcinomas, 4 la rge cell carcinomas, 8 benign lesions, and 2 metastatic lesions. Seven ty-six patients had negative nodes. Nine patients had positive nodes. Every bronchoscopy was visually and cytologically negative. Forty-nine cervical mediastinoscopies were negative. Operating time for the seri es averaged 90.3 minutes. Hospitalization averaged 3.5 days for the en tire group, but was 2.6 days for the last 20 patients. Lesions ranged from 1.5 to 8 cm, averaging 3.4 cm. There was no surgical mortality, n o hemorrhage, no transfusion, and no urgent conversion to an open proc edure. No bronchial fistula, vascular fistula, or bronchovascular fist ula has occurred. Complications included 6 air leaks, 2 cerebrovascula r accidents, 1 infected chest tube site, 2 cases of pneumonitis, and 1 subcutaneous emphysema. Conclusions. Video-assisted thoracic surgical simultaneously stapled lobectomy without rib spreading is a safe oper ation that can be combined with lymph node sampling. At this early sta ge, therapeutic outcomes (survival) for resected neoplasms appear simi lar to results obtained from traditional open techniques. (C) 1997 by The Society of Thoracic Surgeons.