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[Intrathoracic bleeding during video-assisted thoracoscopic lobectomy and segmentectomy]
1Department of Clinical Research, National Sanyo Hospital, Ube, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|October 29, 2003
Summary
Intraoperative bleeding occurred in 45.5% of video-assisted thoracoscopic surgery (VATS) lung cancer procedures, more often in segmentectomies than lobectomies. Most bleeding is controllable thoracoscopically, but significant arterial bleeds may require conversion to open surgery.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Context:
- Video-assisted thoracoscopic surgery (VATS) is increasingly used for early-stage lung cancer.
- Managing intraoperative bleeding during VATS lung resections is critical for patient safety.
- Pulmonary vessel injury is a known complication of VATS lobectomy and segmentectomy.
Purpose:
- To evaluate the incidence and management of intraoperative bleeding from pulmonary vessels during VATS lobectomy and segmentectomy for clinical T1N0M0 lung cancer.
Summary:
- A review of 33 VATS procedures for cT1N0M0 lung cancer (January 2001-January 2003) found intraoperative bleeding in 15 cases (45.5%).
- Bleeding occurred more frequently in VATS segmentectomy compared to VATS lobectomy.
- Most bleeding from pulmonary arteries and veins was managed thoracoscopically via compression, tie, or suture; however, significant pulmonary arterial bleeding necessitated conversion to an open procedure (6.1% of cases).
Impact:
- Findings highlight the importance of preparedness for intraoperative bleeding during VATS lung cancer surgery.
- This study provides insights into the manageability of pulmonary vessel bleeding within a VATS approach.
- Understanding bleeding patterns informs surgical technique refinement and conversion criteria for VATS lung resections.