The Initial Experience on Thoracoscopic Sleeve Lobectomy: Continuous Suturing Technique of the Bronchial Anastomosis in 12 Cases

Background: Sleeve resection is a widely performed type of operation in the surgical treatment of non-small cell lung cancer. Video-assisted thoracoscopic surgery (VATS) is now used even in central tumor surgeries of the lung with the increasing technology and experience. Sleeve resection cases performed through VATS in our clinic in recent years were presented with demographic, surgical, pathologic, and survey characteristics. Materials and Methods: Twelve patients who underwent sleeve resection with VATS in our clinic between November 2015 and August 2019 were included in the study. Operative, pathologic, and postoperative characteristics of the patients were examined. Results: A total of 12 patients, 3 female and 9 male individuals, were included in the study. The mean age of the patients was 61.7 +/- 12.9 years. According to the localization of the tumors, left upper lobectomy was performed in 4 patients and 8 patients underwent right upper lobectomy. During the sleeve anastomosis of the patients, 3/0 prolene sutures were used in 5 patients (36%) and 4/0 prolene sutures in 4 patients (36%), whereas 3/0 polydioxanone suture (PDS) was used in 3 patients (28%). The mean operation time was 288.2 +/- 77.1 (205 to 460) minutes and the mean anastomosis time was 70 +/- 18.5 (55 to 110) minutes. In the postoperative period, 1 patient who had acute myocardial infarction died on the fourth postoperative day. The mean postoperative drainage duration of the patients was 5.5 +/- 1.9 (3 to 10) days and the mean length of hospital stay was 6.4 +/- 1.9 (4 to 11) days. When the pathologic features were examined, the mean tumor diameter was found to be 2.5 +/- 1.2 (1 to 5.5) cm. The mean follow-up period was calculated as 26.1 +/- 15.6 months (2 to 47). Other than 1 patient who died, the follow-up of 11 patients still proceeds. Conclusions: VATS approach of sleeve resections, which is performed cautiously even by thoracotomy, is becoming more common. These operations, which could be performed in experienced centers, offer a postoperative period of less morbidity to the patients with the advantage of reduced postoperative pain, drainage time, and hospital stay.