Cardiothoracic Surgery: Cardiothoracic |

miMRST and VATS Resection for Aged and Cardiopulmonary Dysfunction Patients With Pulmonary Nodules FREE TO VIEW

Jun Zhang, MD; Ning Chen, PhD; Xueshan Qiu, MD
Author and Funding Information

The First Hospital of China Medical University, Shenyang, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A61. doi:10.1016/j.chest.2016.02.064
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SESSION TITLE: Cardiothoracic

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To summary the treatment effect of minimally invasive small incision, muscle- and rib-sparing thoracotomy, minimally invasive lung cancer radical surgery (miMRST) and video-assisted thoracoscopic surgery (VATS) for pulmonary nodules (≤3cm).

METHODS: From Oct 2007, miMRST was developed for aging, cardiopulmonary dysfunction patients with pulmonary nodules, who could not tolerate traditional large-incision standard posterolateral thoracotomy (SPLT), could neither afford VATS. Treatment effect of miMRST and VATS were compared with SPLT.

RESULTS: miMRST was performed for 33 aging, cardiopulmonary dysfunction patients, including 11 wedge resection: 5 harmartoma, 2 inflammatory pseudotumor, 2 tuberculoma, 1 minimally invasive adenocarcinoma (MIA) and 2 adenocarcinoma; 3 lobectomy: 1 hemangioma, 1 pulmonary sclerosing hemangioma and 1 inflammatory pseudotumor; and 18 lobectomy plus mediastinal lymph node dissection: 5 adenocarcinoma in situ (AIS) and 13 adenocarcinoma. VATS was performed for 10 patients, including 5 video-assisted minithoracotomy (VAMT) cases: 3 wedge resection for 2 adenocarcinoma and 1 hemangioma, 2 lobectomy plus mediastinal lymph node dissection for adenocarcinoma; 2 complete VATS: 1 lobectomy for pulmonary sclerosing hemangioma, 1 lobectomy plus mediastinal lymph node dissection for adenocarcinoma; 3 uniportal VATS: wedge resection for 1 MIA, 1 metastasis tumor and 1 inflammatory myofibroblastic tumor. SPLT was performed for 52 adenocarcinoma patients, including 2 wedge resection and 50 lobectomy plus mediastinal lymph node dissection. The average incision length is about 11cm in miMRST, 8cm in VATS and 35cm in SPLT (P<0.001). When compared with SPLT, patients showed less pains from miMRST and VATS, operative-side upper limb recovered freedom of movement quickly and better; walking earlier; chest tube drainaged less and was pulled out earlier; almost no complication happened; could be discharged earlier (P<0.05).

CONCLUSIONS: miMRST and VATS showed significantly less invasive procedures with less complications and and shortened healing time when compared with SPLT, especially for aging, cardiopulmonary dysfunction patients. miMRST costs less.

CLINICAL IMPLICATIONS: miMRST, minimally invasive and not expensive, may be used widely. (Supported by grants from the Education Department of Liaoning Province, China, No. 20060991; the Nature Science Foundation of Liaoning Province, China, No.20102285; and the Fund for Scientific Research of The First Hospital of China Medical University, No.FSFH1210).

DISCLOSURE: The following authors have nothing to disclose: Jun Zhang, Ning Chen, Xueshan Qiu

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