Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer
Abstract Background Bleeding from the pulmonary artery (PA) can be fatal in video‐assisted thoracoscopic surgery (VATS) for lung cancer. We evaluated intraoperative PA injury and assessed precautions for thoracoscopic anatomic pulmonary resection. Methods We retrospectively analyzed a total of 1098...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-11-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.14649 |
| _version_ | 1811194095178088448 |
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| author | Makoto Tomoyasu Hiroyuki Deguchi Satoshi Kudo Wataru Shigeeda Yuka Kaneko Ryuichi Yoshimura Hironaga Kanno Hajime Saito |
| author_facet | Makoto Tomoyasu Hiroyuki Deguchi Satoshi Kudo Wataru Shigeeda Yuka Kaneko Ryuichi Yoshimura Hironaga Kanno Hajime Saito |
| author_sort | Makoto Tomoyasu |
| collection | DOAJ |
| description | Abstract Background Bleeding from the pulmonary artery (PA) can be fatal in video‐assisted thoracoscopic surgery (VATS) for lung cancer. We evaluated intraoperative PA injury and assessed precautions for thoracoscopic anatomic pulmonary resection. Methods We retrospectively analyzed a total of 1098 patients who underwent radical surgery for lung cancer utilizing complete VATS from January 2010 to December 2021. Results A total of 16 patients (1.5%) had PA injury during VATS, while hemostasis was performed by conversion to thoracotomy in eight patients (50.0%). Although there was a significantly greater operation time and blood loss for patients in the PA injury group (318.4 vs. 264.9 min, p = 0.001; 550.3 vs. 60.5 g, p ≤ 0.001, respectively), there was no significant different for the chest tube insertion duration and length of postoperative hospital stay (4.9 vs. 7.8 days, p = 0.157; 10.6 vs. 9.9 days, p = 0.136, respectively). There was a significant difference observed for the surgical procedure related to the left upper lobectomy in the PA injury group (43.8 vs. 18.8%, p = 0.012), with the primary causative PA determined to be the left anterior segmental PA (A3) (31.3%). Conclusions VATS is both feasible and safe for lung cancer treatment provided the surgeon performs appropriate hemostasis, although fatal vascular injury could potentially occur during VATS. Surgeons need to be aware of the pitfalls regarding PA dissection management. |
| first_indexed | 2024-04-12T00:20:22Z |
| format | Article |
| id | doaj.art-a23986ce54ed44aa98f6737dcc2261d2 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-12T00:20:22Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-a23986ce54ed44aa98f6737dcc2261d22022-12-22T03:55:44ZengWileyThoracic Cancer1759-77061759-77142022-11-0113213001300610.1111/1759-7714.14649Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancerMakoto Tomoyasu0Hiroyuki Deguchi1Satoshi Kudo2Wataru Shigeeda3Yuka Kaneko4Ryuichi Yoshimura5Hironaga Kanno6Hajime Saito7Department of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanDepartment of Thoracic Surgery, School of Medicine Iwate Medical University Yahaba, Shiwa Iwate JapanAbstract Background Bleeding from the pulmonary artery (PA) can be fatal in video‐assisted thoracoscopic surgery (VATS) for lung cancer. We evaluated intraoperative PA injury and assessed precautions for thoracoscopic anatomic pulmonary resection. Methods We retrospectively analyzed a total of 1098 patients who underwent radical surgery for lung cancer utilizing complete VATS from January 2010 to December 2021. Results A total of 16 patients (1.5%) had PA injury during VATS, while hemostasis was performed by conversion to thoracotomy in eight patients (50.0%). Although there was a significantly greater operation time and blood loss for patients in the PA injury group (318.4 vs. 264.9 min, p = 0.001; 550.3 vs. 60.5 g, p ≤ 0.001, respectively), there was no significant different for the chest tube insertion duration and length of postoperative hospital stay (4.9 vs. 7.8 days, p = 0.157; 10.6 vs. 9.9 days, p = 0.136, respectively). There was a significant difference observed for the surgical procedure related to the left upper lobectomy in the PA injury group (43.8 vs. 18.8%, p = 0.012), with the primary causative PA determined to be the left anterior segmental PA (A3) (31.3%). Conclusions VATS is both feasible and safe for lung cancer treatment provided the surgeon performs appropriate hemostasis, although fatal vascular injury could potentially occur during VATS. Surgeons need to be aware of the pitfalls regarding PA dissection management.https://doi.org/10.1111/1759-7714.14649left anterior segmental pulmonary artery (A3)pulmonary artery injuryvascular staplervideo‐assisted thoracoscopic surgery |
| spellingShingle | Makoto Tomoyasu Hiroyuki Deguchi Satoshi Kudo Wataru Shigeeda Yuka Kaneko Ryuichi Yoshimura Hironaga Kanno Hajime Saito Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer Thoracic Cancer left anterior segmental pulmonary artery (A3) pulmonary artery injury vascular stapler video‐assisted thoracoscopic surgery |
| title | Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer |
| title_full | Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer |
| title_fullStr | Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer |
| title_full_unstemmed | Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer |
| title_short | Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer |
| title_sort | evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer |
| topic | left anterior segmental pulmonary artery (A3) pulmonary artery injury vascular stapler video‐assisted thoracoscopic surgery |
| url | https://doi.org/10.1111/1759-7714.14649 |
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