Safety and feasibility of preferential manual bronchoplasty in 2-3 cm single-port video-assisted thoracoscopic lobectomy

Sep 28, 2026

Uploaded by Bintang

Background: This retrospective study compared preferential manual bronchoplasty (PMB) with mechanical stapler closure (MSC) of the bronchial stump after 2–3 cm single-port (SP) video-assisted thoracoscopic surgery (VATS) lobectomy in patients with pathological T1 (pT1) stage lung cancer. Methods: From January 2019 to March 2022, patients undergoing 2–3 cm SP VATS lobectomy were screened and propensity-matched, then perioperative outcomes were compared. Results: 280 PMB and 832 MSC patients were enrolled, forming 280 matched pairs; PMB shortened operation time, increased lymph node dissection, and reduced conversion and postoperative atelectasis. Conclusions: For pT1 lung cancer SP VATS superior lobectomies, PMB showed better safety and feasibility than MSC.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Methods

Patient selection

Preoperative evaluation

Results

Conclusions

DOI: 10.1111/1759-7714.15033 ORIGINA L ARTICLE Safety and feasibility of preferential manual bronchoplastyin 2–3 cm single-port video-assisted thoracoscopic lobectomy Kang Qi 1 | Gang Lin 1 | Haibo Liu 1 | Xining Zhang 1 | Weiming Huang 1 | Zhimao Chen 2 | Jian Li 1 1Department of Thoracic Surgery, Peking University First Hospital, Beijing, China 2Department of Precision Medicine in Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands Correspondence Jian Li, Department of Thoracic surgery, Peking University First Hospital, Beijing, China. Email: [lijiansurgeon@163.com](lijiansurgeon@163.com) Funding information Seed Fund of Peking University First Hospital, Grant/Award Number: 2018SF078 Abstract Background: This retrospective study aimed to compare preferential manual bronchoplasty (PMB) and mechanical stapler closure (MSC) of the bronchial stump after 2–3 cm single-port (SP) video-assisted thoracoscopic surgery (VATS) lobectomyin patients with pathological T1 (pT1) stage lung cancer. Methods: Between January 2019 and March 2022, patients with pulmonary neoplasms who underwent 2–3 cm SP VATS lobectomy were retrospectively screened. After propensity-matched analysis, we compared perioperative outcomes and analyzed the safety and feasibility of PMB and MSC of the bronchial stump while performing VATS lobectomy. Results: In this study, 280 and 832 patients were enrolled in the PMB and MSC groups, respectively. Propensity score matching produced 280 pairs. The operation time was shorter in the PMB group, whereas the average number of lymph nodes dissected was higher in the PMB group. The conversion rate was significantly lower in the PMB group. The following were similar between the PMB and MSC groups, respectively: average blood loss volume, postoperative hospital stay, and chest tube removal time. Postoperatively, the incidence of atelectasis was significantly higher in the MSC group. As per subgroup analyses, PMB was associated with a shorter operation time in left and right upper lobectomies. Particularly in left upper lobectomy, PMB had more lymph node dissectionsand less conversion to open and postoperative atelectasis. Conclusions: In comparison with MSC of the bronchial stump, PMB showed better safety and feasibility in 2–3 cm SP VATS left and right superior lobectomies inpatients with pT1 stage lung cancer. KEYW ORD S lung cancer, mechanical stapler closure, preferential manual bronchoplasty, video-assisted thoracoscopic lobectomy INTRODUCTION Single-port (SP) video-assisted thoracoscopic surgery (VATS) has become a conventional thoracic surgical procedure for lung cancer in recent years. 1,2 Rocco et al. first reported on SP VATS 􀀁 20 years ago.3 Subsequently, SP thoracoscopy has evolved rapidly and in 2011, Gonzalez-Rivas et al.4 developed an SP technique for thoracoscopic lobectomy. With the development of surgical techniques, thoracic surgeons are now able to perform complex thoracic surgery.5–7 Compared to the traditional multiport VATS technique, the SP VATS approach may have potential advantages, including faster postoperative recovery, less postoperative pain, better cosmetic incision, and less impact on pulmonary function.8–10 Bronchial priority has been reported as a lobectomy procedure for open lobectomy.11 Because both the endoscope and surgical instruments need to be inserted into the chest cavity through a single port, the instruments interfere with each other, and the operating angles are limited, especially the difficulty in placing the endoscopic stapler. Because the bronchus is This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wi

FAQs

What was the purpose of comparing PMB and MSC in this study?

The study aimed to compare preferential manual bronchoplasty (PMB) versus mechanical stapler closure (MSC) of the bronchial stump after 2–3 cm single-port VATS lobectomy in pT1 lung cancer patients.

How were patients assigned for comparison?

Patients who underwent 2–3 cm single-port SP VATS lobectomy between January 2019 and March 2022 were retrospectively screened, and propensity score matching produced 280 matched pairs.

Which approach showed better postoperative safety and feasibility outcomes?

PMB demonstrated better safety and feasibility than MSC, with shorter operation time, higher lymph node dissection, and a significantly lower conversion rate; postoperative atelectasis incidence was higher in the MSC group.

Sep 28, 2026

Uploaded by Bintang