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W. Wang

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    P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P1.02-025 - Complete VATS Resection and Reconstruction of Carina and Trachea for Malignant or Benign Disease (ID 1218)

      09:30 - 17:00  |  Author(s): W. Wang

      • Abstract

      General thoracic surgery involving carinal and/or tracheal reconstruction is technically demanding. The aim of this study is to discuss the feasibility of complete video assisted thoracoscopic surgery (VATS) in the surgical treatment of disease involving the carina and/or trachea.

      Between May 2012 and April 2015, seven cases of malignant or benign disease involving carina and/or trachea were treated via complete VATS resection and reconstruction of carina and trachea in our hospital. Among the seven patients (median age, 47 years; range, 43-60 years), two patients suffered from a malignant tracheal tumor, one from a main bronchial malignant tumor invading the carina, two from right upper lobe malignant tumor invading the carina, and two from benign bronchial stenosis due to endobronchial tuberculosis. A prospective analysis of clinical characteristics, operative data, and postoperative events was performed. Figure 1

      There were five different types of VATS airway reconstruction in our group, including left main bronchus resection and carinal reconstruction, right main bronchus resection and carinal reconstruction, right upper lobectomy and carinal reconstruction, right upper lobectomy and half carinal reconstruction, and tracheal resection and reconstruction. Median data of surgical outcome are as follows: operative time-200 minutes (range, 50-300 minutes); time of airway reconstruction-50 minutes (range, 19-130 minutes); blood loss-100 mL (range, 30-1000 mL). One patient suffered from endobronchial tuberculosis; during the thoracic procedure we observed complete pleural adhesions which led to large volume of blood loss during pleuropneumonolysis. No conversions to thoracotomy were performed. There was no 30-day mortality. Median data of perioperative outcomes are as follows: postoperative hospital stay-12 days (range, 7-15 days); ICU stay -1 day (range, 0-6 days) and duration of thoracic drainage- 2 days (range, 1-5 days). No patient required postoperative mechanical ventilation. One patient had to be assisted with bronchoscopy as a result of insufficient sputum excretion. Median duration of follow-up was 6 months (range, 0-37 months). Minor anastomotic stenosis(less than 1/4 diameter) was found in two patients during follow-up, but no complaints of significant impact on activity were noted.

      Complete VATS for carina and trachea resection and reconstruction is a technically challenging, but feasible procedure for both benign and malignant disease and should be restricted to skilled VATS surgeons.