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Application of the "continuous suture dividing and equal suture tightening" method in video-assisted thoracoscopic surgery sleeve lobectomy

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单位: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Thorac Surg, Wuhan 430030, Hubei, Peoples R China [2]Qingdao Univ, Affiliated Yantai Yuhuangding Hosp, Dept Thorac Surg, Yantai 264001, Peoples R China
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关键词: Video-assisted thoracoscopic surgery sleeve lobectomy (VATS sleeve lobectomy) bronchial anastomosis continuous suture tightening suture

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Background: The primary focus of video-assisted thoracoscopic surgery (VATS) sleeve lobectomy is bronchial anastomosis. Both interrupted suture and continuous suture cannot overcome entanglement of the suture threads. The present study used the "continuous suture dividing and equal suture tightening" method in VATS sleeve lobectomy for bronchial anastomosis and discussed the feasibility of this approach. Methods: A total of 17 patients underwent VATS sleeve lobectomy with bronchial anastomosis using the "continuous suture dividing and equal suture tightening" method. Four incisions were utilized in the operation as follows: (I) the pulmonary arteries and veins were cut-off using an endoscopic linear stapler. Systematic hilar and mediastinal lymph node dissection was performed; (II) the surgeon used a surgical knife for incision into the thoracic cavity and to cut the lung lobe and main bronchi. Intraoperative pathological analysis revealed negative bronchial margins; (III) the "continuous suture dividing and equal suture tightening" method was performed for anastomosis; (IV) the integrity of the anastomosis was assessed by intraoperative bronchoscopy. Computed tomography (CT), three-dimensional (3D) reconstruction and bronchoscopy assessed the anastomosis 1-week postoperatively. A follow-up was conducted using a 3-month bronchoscopy, and CT scans monitored the recurrence and stenosis of the anastomosis. Results: The method was successfully completed for VATS sleeve lobectomy with bronchial anastomosis in 17 cases. Although various histological profiles were observed, the 1-week postoperative CT and bronchoscopy showed adequate healing of the anastomotic stoma as well as the absence of postoperative mortality and bronchial pleural fistula. All patients were alive and followed up for 31-49 months postoperatively; local recurrence and anastomotic stenosis were not detected. Conclusions: The continuous suture dividing and equal suture tightening method is convenient, feasible, and safe for bronchial anastomosis in VATS sleeve lobectomy. It can effectively avoid the entanglement of the suture threads, thereby enabling the widespread adoption of VATS sleeve lobectomy.

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出版当年[2017]版:
大类 | 4 区 医学
小类 | 4 区 呼吸系统
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 呼吸系统
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Q3 RESPIRATORY SYSTEM
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Q3 RESPIRATORY SYSTEM

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Thorac Surg, Wuhan 430030, Hubei, Peoples R China [2]Qingdao Univ, Affiliated Yantai Yuhuangding Hosp, Dept Thorac Surg, Yantai 264001, Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Thorac Surg, Wuhan 430030, Hubei, Peoples R China [*1]Tongji Hosp, Dept Thorac Surg, Jiefang Dadao St 1095, Wuhan 430030, Hubei, Peoples R China
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