title: Thoracoscopic double sleeve lobectomy in 13 patients: a series report from multi-centers.
abstract: BACKGROUND
  This study aims to explore the feasibility and safety of video-assisted thoracic surgery (VATS) double sleeve lobectomy in patients with non-small lung cell cancer (NSCLC).
  
  
  METHODS
  Between June 2012 and August 2014, 13 NSCLC patients underwent thoracoscopic double sleeve lobectomy and mediastinal lymphadenectomy at three institutions. A retrospective analysis of clinical characteristics, operative data, postoperative events and follow-up was performed.
  
  
  RESULTS
  Thirteen NSCLC patients (median age, 60 years; range, 43-67 years) underwent thoracoscopic double sleeve lobectomy. There were no conversions to thoracotomy. Left upper lobectomy was most frequently performed (eleven patients). Median operative time was 263 minutes (range, 218-330 minutes), and median blood loss was 224 mL (range, 60-400 mL). The learning curve revealed reductions in both operative times and blood loss of ten cases from one center. Median data were duration of blocking pulmonary artery (PA) 72 minutes (range, 44-143 minutes), resected lymph nodes 24 (range, 10-46), stations of retrieved lymph nodes 6 (range, 5-9), thoracic drainage 1,042 mL (range, 500-1,700 mL), duration of thoracic drainage 5 days (range, 3-8 days), postoperative hospital stay 10 days (range, 7-20 days), and ICU stay 1 day (range, 1-2 days). One patient (1/13, 7.70%) suffered from pneumonia after surgery. There were no deaths at 30 days. Median duration of follow-up was 6 months (range, 1-26 months). And no local recurrences or distant metastasis were reported.
  
  
  CONCLUSIONS
  Thoracoscopic double sleeve lobectomy is a technically challenging, but feasible procedure for NSCLC patients and it should be restricted to skilled VATS surgeons.
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Jingpei
authors.initials: J
authors.lastname: Li
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Dmitrii
authors.initials: D
authors.lastname: Sekhniaidze
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Hanzhang
authors.initials: H
authors.lastname: Chen
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Gonzalez-Rivas
authors.affiliation: 1 Department of Thoracic Surgery, Guangzhou Medical University First Affiliated Hospital, Guangzhou 510120, China ; 2 Guangzhou Institute of Respiratory Disease, Guangzhou 510120, China ; 3 Key cite of National Clinical Research Center for Respiratory Diseases, Guangzhou 510120, China ; 4 Thoracic Surgery Department, Regional Oncological Center, Tyumen, Russian Federation ; 5 Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain ; 6 Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
keywords: Non-small lung cell cancer (NSCLC); learning curve; sleeve lobectomy; video-assisted thoracic surgery (VATS)