title: Completely thoracoscopic lobectomy for the surgical management of bronchiectasis.
abstract: BACKGROUND
  The feasibility of completing a lobectomy by completely video-assisted thoracoscopic surgery (cVATS) in the management of bronchiectasis is unclear. By retrospectively comparing the outcomes from the lobectomies that used thoracotomy vs. cVATS, we determined the appropriateness of the minimally invasive cVATS approach in the management of bronchiectasis.
  
  
  METHODS
  Between June 2001 and October 2010, 60 patients with bronchiectasis underwent surgery, of which 56 lobectomies were performed. All lobectomies were carried out by either thoracotomy or cVATS approach. Pulmonary vessels and bronchi were manipulated by ligation or stapler in the thoracotomy group, while they were dissected by endo-cutters in the cVATS group.
  
  
  RESULTS
  There were 21 patients in the thoracotomy group and 35 patients in the cVATS group. Two cVATS patients (5.7%) converted. The difference in operation time, chest tube duration, lengths of hospitalization, and morbidity were not significantly different between the two groups (P > 0.05). The blood loss was less in the cVATS group (P = 0.015). A total of 52.4% and 62.9% of patients were postoperatively asymptomatic in the thoracotomy and cVATS groups respectively, and symptomatic improvement was obtained in 38.1% patients by thoracotomy vs. 31.4% patients by cVATS.
  
  
  CONCLUSIONS
  cVATS lobectomy is safe and effective for the management of bronchiectasis, especially for the patients with localized lesions.
authors.affiliation: Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Zu-li
authors.initials: ZL
authors.lastname: Zhou
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.forename: Jian-feng
authors.initials: JF
authors.lastname: Li
authors.forename: Guan-chao
authors.initials: GC
authors.lastname: Jiang
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*