Initial experience of thoracoscopic lobectomy with partial removal of the superior vena cava for lung cancers

Objectives: The objectives of this study were to report the surgical techniques and clinical outcome of thoracoscopic lobectomy with partial removal of the superior vena cava for lung carcinomas.

Methods: Between January 2010 and November 2013, 1132 patients with lung cancer underwent radical surgery by thoracoscopy; 5 (0.4%) underwent thoracoscopic lobectomy with partial removal of the superior vena cava. Perioperative variables and postoperative outcomes of these cases were analysed to evaluate the technical feasibility and safety of this operation.

Results: For all cases, a right upper lobectomy was performed. The average time of surgery was 260 min (range, 170-380, 260±90 min).The intraoperative blood loss averaged 160 ml (range, 50-300, 160±90 ml). The median postoperative hospital stay was 11 days (interquartile range, 7-15 days). Postoperatively, tracheal extubation was achieved in the recovery room without further need for mechanical ventilation. In 1 case, the patient experienced postoperative superior vena cava thrombosis; he recovered after administration of anticoagulation drugs. None of the patients developed active blood leakage postoperatively. Perioperative mortality was not observed.

Conclusion: Thoracoscopic lobectomy with partial removal of the superior vena cava can be considered a feasible and safe operation for selected patients with lung cancer.