Takashi Suda, Yuka Kitamura, Sachiko Tochii, Hiroshi Sugimura, Yoshinobu Hattori.
Fujita Health University School of Medicine, Toyoake, Japan.
OBJECTIVE: Herein we describe extrapleural pneumonectomy by video-assisted thoracoscopic surgery without rib spreading as a new approach to extrapleural pneumonectomy for malignant pleural mesothelioma.
METHODS: We first performed this surgery in July of 2006 and to date have performed it for three cases. Four incisions are made: a 12 cm access incision under the costal arch, a 4 cm in the mid-axillary line in the 4th intercostal space, and 1 cm incisions in the anterior axillary line in the 6th intercostal space and the posterior axillary line in the 8th intercostal space. There is no rib spreading. The resected pleura, lung, diaphragm and pericardium were removed en bloc through the access incision below the costal arch.
RESULTS: Mean operating room time were 656.3 min. and mean blood loss were 1405.7 g. There were no surgery-related deaths.
CONCLUSIONS: Minimally invasive exrapleural pneumonectomy can be performed safely.
This work is published in The Journal of Thoracic and cardiovascular Surgery 2007 Oct.134:1088-9. We present this work by video.
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