Outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIANG Baolei ^1,2 ,  CAI Qingyong ¹ , LIANG Guiyou ¹ , WEI Hao ¹ , SHI Ke ¹ , SHAO Changhai ¹ , TANG Yang ¹ , CHEN Anping ¹ , XU gang ¹

1. Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, 563000, Guizhou, P.R.China;
2. Department of Thoracic Surgery, Heilongjiang Forestry Second Hospital, Yichun, 153100, Heilongjiang, P.R.China;

Corresponding author：

CAI Qingyong, Email: cqy008cqy@163.com

Keywords：

Subxiphoid; video-assisted thoracoscopic surgery; bilateral chest diseases

DOI：

10.7507/1007-4848.201804009

Video：

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Objective To summarize clinical outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases simultaneously. Methods The clinical data of 60 patients with bilateral chest diseases treated by uniportal thoracoscopic surgery via subxiphoid approach in the Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical College from August 2016 to December 2017 were retrospectively analyzed. There were 35 males and 25 females, aged 25.5±8.8 years ranging from 13 to 51 years. There were 40 patients wtih palmar hyperhidrosis, and 20 patients with bilateral pulmonary bullae and onset of one-side pneumothorax. All patients adopted subxiphoid uniportal video-assisted thoracoscopic surgery. Among them 36 patients with palmar hyperhidrosis underwent resection of R3 bilateral sympathetic nerves, 1 resection of R4 bilateral sympathetic nerves, 3 resection of R3+R4 bilateral sympathetic nerves, and 20 patients with pulmonary bullae underwent bilateral bullectomy and pleurodesis. Results Fifty-five patients cured within 1 to 4 days and discharged after surgery. One patient with incision infection and pulmonary infection after bullectomy, cured and discharged after 3 weeks anti-inflammation and incision dressing change. Four patients with Grade B healing recovered after 1 to 2 weeks dressing change. During the follow-up, no pneumothorax or hand perspiration relapsed. Conclusion Subxiphoid uniportal video-assisted thoracoscopic surgery for simple bilateral chest disease simultaneously is safe and feasible, which not only avoids simultaneous trauma of bilateral punch, but also alleviates the pain of patients.

Citation： LIANG Baolei, CAI Qingyong, LIANG Guiyou, WEI Hao, SHI Ke, SHAO Changhai, TANG Yang, CHEN Anping, XU gang. Outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(12): 1064-1067. doi: 10.7507/1007-4848.201804009 Copy

1.	White A, Swanson SJ. Video-assisted thoracic surgery (VATS) segmentectomy: State of the art. Minerva Chir, 2016, 71(1): 61-66.
2.	Kim KS. Single-staged uniportal VATS in the supine position for simultaneous bilateral primary spontaneous pneumothorax. J Cardiothoracic Surg, 2017, 12(1): 1-5.
3.	Yang X, Wang L. Subxiphoid uniportal video-assisted thoracoscopic surgery for synchronous bilateral lung resection. Postgrad Med, 2017, 130(1): 142-145.
4.	蔡昊旻, 林磊, 吴亮, 等. 经剑突下单孔胸腔镜同期双肺下叶切除术 2 例. 中华胸心血管外科杂志, 2017, 33(10): 608-609.
5.	乔贵宾, 陈刚. 自发性气胸的处理: 广东胸外科行业共识(2016 年版). 中国胸心血管外科临床杂志, 2017, 24(1): 6-15.
6.	Askari A, Kordzadeh A, Lee GH, et al. Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre. Surge-J R Coll Surg E, 2014, 12(1): 130-133.
7.	Paliouras D, Barbetakis N, Lazaridis G, et al. Video-assisted thoracic surgery and pneumothorax. J Thorac Dis, 2015, 7(1): 56-61.
8.	Herrmann D, Klapdor B, Ewig S, et al. Initial management of primary spontaneous pneumothorax with video-assisted thoracoscopic surgery: a 10-year experience. Eur J Cardio-Thorac, 2016, 49(3): 854-859.
9.	Cardillo G, Bintcliffe OJ, Carleo F, et al. Primary spontaneous pneumothorax: a cohort study of VATS with talc poudrage. Thorax, 2016, 71(9): 847-853.
10.	Bagheri R, Sharifian AA, Haghi SZ, et al. Thoracoscopic sympathicotomy in the treatment of palmar hyperhidrosis. Asian Cardiovasc Thorac Ann, 2016, 24(7): 687-691.
11.	Laje P, Rhodes K, Magee L, et al. Thoracoscopic bilateral T3 sympathectomy for primary focal hyperhidrosis in children. J Pediatr Surg, 2016, 52(2): 313-316.
12.	王先学, 潘道波, 邓恢伟, 等. 不同节段胸交感神经切断术对手汗症患者术后影响的系统评价与 Meta 分析. 中国胸心血管外科临床杂志, 2017, 24(5): 377-383.
13.	刘涛, 何海丽, 郭建极, 等. 经剑突单孔胸腔镜同期切除双侧肺肿瘤 11 例. 中华实验外科杂志, 2017, 34(4): 706-706.
14.	Wang BY, Chang YC, Chang YC, et al. Thoracoscopic surgery via a single-incision subxiphoid approach is associated with less postoperative pain than single-incision transthoracic or three-incision transthoracic approaches for spontaneous pneumothorax. J Thorac Dis, 2016, 8(Suppl 3): S272-S278.
15.	张国瑜, 张双林, 张清勇, 等. 经剑突下单孔胸腔镜治疗双侧胸部疾病. 中华实验外科杂志, 2015, 32(10): 2581-2582.
16.	章智荣, 毛友生, 高树庚, 等. 双侧同时多原发性非小细胞肺癌外科治疗疗效分析. 中华肿瘤杂志, 2016, 38(6): 460-465.
17.	Li X, Hu B, Miao J, et al. Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection. J Thorac Dis, 2016, 8(Suppl 1): S93-S98.
18.	Chou YP, Lin HL, Wu TC. Video-assisted thoracoscopic surgery for retained hemothorax in blunt chest trauma. Curr Opin Pulm Med, 2015, 21(4): 393-398.
19.	Suda T, Sugimura H, Tochii D, et al. Single-port thymectomy through an infrasternal approach. Ann Thorac Surg, 2012, 93(1): 334-336.
20.	Berry MF. Pulmonary artery bleeding during video-assisted thoracoscopic surgery: intraoperative bleeding and control. Thorac Surg Clin, 2015, 25(3): 239-247.
21.	Agostini P, Lugg ST, Adams K, et al. S61 Risk factors and short-term outcomes of developing postoperative pulmonary complications after vats lobectomy. Thorax, 2016, 71(3): 36-37.
22.	陈舒晨, 余绍斌, 林济红, 等. 经剑突下入路胸腔镜下前纵隔肿瘤切除术学习曲线分析. 福建医科大学学报, 2017, 51(5): 311-315.

1. White A, Swanson SJ. Video-assisted thoracic surgery (VATS) segmentectomy: State of the art. Minerva Chir, 2016, 71(1): 61-66.
2. Kim KS. Single-staged uniportal VATS in the supine position for simultaneous bilateral primary spontaneous pneumothorax. J Cardiothoracic Surg, 2017, 12(1): 1-5.
3. Yang X, Wang L. Subxiphoid uniportal video-assisted thoracoscopic surgery for synchronous bilateral lung resection. Postgrad Med, 2017, 130(1): 142-145.
4. 蔡昊旻, 林磊, 吴亮, 等. 经剑突下单孔胸腔镜同期双肺下叶切除术 2 例. 中华胸心血管外科杂志, 2017, 33(10): 608-609.
5. 乔贵宾, 陈刚. 自发性气胸的处理: 广东胸外科行业共识(2016 年版). 中国胸心血管外科临床杂志, 2017, 24(1): 6-15.
6. Askari A, Kordzadeh A, Lee GH, et al. Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre. Surge-J R Coll Surg E, 2014, 12(1): 130-133.
7. Paliouras D, Barbetakis N, Lazaridis G, et al. Video-assisted thoracic surgery and pneumothorax. J Thorac Dis, 2015, 7(1): 56-61.
8. Herrmann D, Klapdor B, Ewig S, et al. Initial management of primary spontaneous pneumothorax with video-assisted thoracoscopic surgery: a 10-year experience. Eur J Cardio-Thorac, 2016, 49(3): 854-859.
9. Cardillo G, Bintcliffe OJ, Carleo F, et al. Primary spontaneous pneumothorax: a cohort study of VATS with talc poudrage. Thorax, 2016, 71(9): 847-853.
10. Bagheri R, Sharifian AA, Haghi SZ, et al. Thoracoscopic sympathicotomy in the treatment of palmar hyperhidrosis. Asian Cardiovasc Thorac Ann, 2016, 24(7): 687-691.
11. Laje P, Rhodes K, Magee L, et al. Thoracoscopic bilateral T3 sympathectomy for primary focal hyperhidrosis in children. J Pediatr Surg, 2016, 52(2): 313-316.
12. 王先学, 潘道波, 邓恢伟, 等. 不同节段胸交感神经切断术对手汗症患者术后影响的系统评价与 Meta 分析. 中国胸心血管外科临床杂志, 2017, 24(5): 377-383.
13. 刘涛, 何海丽, 郭建极, 等. 经剑突单孔胸腔镜同期切除双侧肺肿瘤 11 例. 中华实验外科杂志, 2017, 34(4): 706-706.
14. Wang BY, Chang YC, Chang YC, et al. Thoracoscopic surgery via a single-incision subxiphoid approach is associated with less postoperative pain than single-incision transthoracic or three-incision transthoracic approaches for spontaneous pneumothorax. J Thorac Dis, 2016, 8(Suppl 3): S272-S278.
15. 张国瑜, 张双林, 张清勇, 等. 经剑突下单孔胸腔镜治疗双侧胸部疾病. 中华实验外科杂志, 2015, 32(10): 2581-2582.
16. 章智荣, 毛友生, 高树庚, 等. 双侧同时多原发性非小细胞肺癌外科治疗疗效分析. 中华肿瘤杂志, 2016, 38(6): 460-465.
17. Li X, Hu B, Miao J, et al. Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection. J Thorac Dis, 2016, 8(Suppl 1): S93-S98.
18. Chou YP, Lin HL, Wu TC. Video-assisted thoracoscopic surgery for retained hemothorax in blunt chest trauma. Curr Opin Pulm Med, 2015, 21(4): 393-398.
19. Suda T, Sugimura H, Tochii D, et al. Single-port thymectomy through an infrasternal approach. Ann Thorac Surg, 2012, 93(1): 334-336.
20. Berry MF. Pulmonary artery bleeding during video-assisted thoracoscopic surgery: intraoperative bleeding and control. Thorac Surg Clin, 2015, 25(3): 239-247.
21. Agostini P, Lugg ST, Adams K, et al. S61 Risk factors and short-term outcomes of developing postoperative pulmonary complications after vats lobectomy. Thorax, 2016, 71(3): 36-37.
22. 陈舒晨, 余绍斌, 林济红, 等. 经剑突下入路胸腔镜下前纵隔肿瘤切除术学习曲线分析. 福建医科大学学报, 2017, 51(5): 311-315.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases

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