The causes and consequences of conversions during thoracoscopic anatomical lung resections

Bagrov V.A.

P.A. Hertzen Moscow Research Institute of Oncology, Russian Federation, Moscow

Ryabov A.B.

Hertsen Moscow Oncology Research Center, Moscow, Russia

Pikin O.V.

FGBU "MNIOI im. P.A. Gertsena" Minzdrava Rossii

Kolbanov K.I.

Moskovskiĭ nauchno-issledovatel'skiĭ onkologicheskiĭ institut im. P.A. Gertsena Rosmedtekhnologiĭ

Glushko V.A.

P.A. Gertsen Moscow Research Cancer Institute, Russian Ministry of Health

Vursol D.A.

P.A. Hertzen Moscow Research Institute of Oncology, Russian Federation, Moscow

Amiraliyev A.M.

P.A. Gertsen Moscow Research Cancer Institute, Russian Ministry of Health

Rudakov R.V.

FGBU "Moskovskiĭ nauchno-issledovatel'skiĭ onkologicheskiĭ institut im. P.A. Gertsena" Minzdravsotsrazvitiia Rossii

Barmin V.V.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova;
Uchebno-nauchnyĭ meditsinskiĭ tsentr UD Prezidenta RF, Moskva

The causes and consequences of conversions during thoracoscopic anatomical lung resections

Authors:

Bagrov V.A., Ryabov A.B., Pikin O.V., Kolbanov K.I., Glushko V.A., Vursol D.A., Amiraliyev A.M., Rudakov R.V., Barmin V.V.

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Journal: P.A. Herzen Journal of Oncology. 2017;6(3): 11‑16

DOI: 10.17116/onkolog20176311-16

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To cite this article:

Bagrov VA, Ryabov AB, Pikin OV, et al. . The causes and consequences of conversions during thoracoscopic anatomical lung resections. P.A. Herzen Journal of Oncology. 2017;6(3):11‑16. (In Russ.)
https://doi.org/10.17116/onkolog20176311-16

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Objective. To improve the immediate results of thoracoscopic anatomical lung resections via lobectomy in patients with malignant lung tumors, by reducing the number of conversions to thoracotomy. Material and methods. The investigators used the data of the Thoracic Surgery Department, P.A. Herzen Moscow Oncology Research Institute, over 6 years (2010—2015 inclusive), which in this period made 219 thoracoscopic anatomical lung resections (lobectomies), including 47 operations completed through a thoracotomy approach as a result of conversion. They comparatively analyzed the immediate results of the operations completed thoracoscopically and through conversion to thoracotomy and compared elective and emergency conversion rates. Results. The overall conversion rate throughout the follow-up period was 21.5% (47/219), the time course of changes in the rate of conversion was traced when mastering the technique of thoracoscopic lobectomy. The transition to thoracotomy was due to a marked adhesive process in the pleural cavity in 55.4% (26/47) of cases; to cancer causes (lymph node lesions of the lung root or mediastinum with invasion into the major vessels or tumor spread to the lobar bronchus) in 23.4% (11/47); to conversion resulting from hemorrhage in 19.1% (9/47), and to bronchial wound in 2.1% (1/47). Conclusion. Despite the existing transition rate of thoracoscopic surgery to thoracotomy, minimally invasive surgery for malignant lung tumors via lobectomy can be considered safe enough. Timely conversion (i.e. the so-called planned transition to thoracotomy) fails to increase the number of postoperative complications. The conversion rate depends mainly on a surgeon’s experience and decreases as the latter accumulates.

Keywords:

thoracoscopic lobectomy

conversion

Authors:

Bagrov V.A.

P.A. Hertzen Moscow Research Institute of Oncology, Russian Federation, Moscow

Ryabov A.B.

Hertsen Moscow Oncology Research Center, Moscow, Russia

Pikin O.V.

FGBU "MNIOI im. P.A. Gertsena" Minzdrava Rossii

Kolbanov K.I.

Moskovskiĭ nauchno-issledovatel'skiĭ onkologicheskiĭ institut im. P.A. Gertsena Rosmedtekhnologiĭ

Glushko V.A.

P.A. Gertsen Moscow Research Cancer Institute, Russian Ministry of Health

Vursol D.A.

P.A. Hertzen Moscow Research Institute of Oncology, Russian Federation, Moscow

Amiraliyev A.M.

P.A. Gertsen Moscow Research Cancer Institute, Russian Ministry of Health

Rudakov R.V.

FGBU "Moskovskiĭ nauchno-issledovatel'skiĭ onkologicheskiĭ institut im. P.A. Gertsena" Minzdravsotsrazvitiia Rossii

Barmin V.V.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova;
Uchebno-nauchnyĭ meditsinskiĭ tsentr UD Prezidenta RF, Moskva

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