Surgery has remained the cornerstone of lung cancer therapy. Sleeve lobectomy, which is featured by not only the maximal resection of tumors but also the maximal preservation of functional lung parenchyma, has been proved to be a valid therapeutic option for the treatment of some centrally located lung cancer . Evidence points toward equivalent oncologic outcomes with improved survival and quality of life after sleeve resections compared with pneumonectomy. However, the postoperative morbidities and the long-term results after sleeve lobectomy remain controversial, especially in relation to nodal involvement and after induction therapy. With the development of technology, minimally invasive procedures have been performed more and more widely.

Objective:To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods:We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results:The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min, intraoperative blood loss was(105.0±27.5)ml, thoracic drainage time was(4.5±1.5)days, and postoperative hospital stay was(5.3±2.5)days. The postoperative quality of life of the patients was satisfactory. Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation, and the reconstructed vessels were unobstructed in the other patients. The average follow-up time of the patients was 34.3 months after surgery. One patient developed chest wall metastasis 23 months after surgery, and his condition was stable after receiving local radiotherapy. The other 5 patients did not occur local recurrence or distant metastasis.Conclusion:The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method, and its clinical application prospect is worth expecting.

Objective To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS).Methods A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014.Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery.Twenty-one pairs (42 cases) patients were included for analysis.The t-test,x2 test or Fisher's exact probabilities was adopted,if appropriate,to compare demographics and outcomes between the 2 groups.The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons.Results After propensity score-matched analysis,the VATS group had a longer operative time ((296.9±73.6) minutes vs.(218.1±59.2) minutes,t =3.82,P=0.00),but shorter postoperative drainage time ((3.3±1.5) days vs.(2.0±3.0) days,t=-0.93,P=0.01) and hospitalization time((6.7±2.8) days vs.(12.1±8.7)days,t=-1.72,P=0.01) than that of the thoracotomy group.Perioperative complications,1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups.Conclusion For suitable patients,sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.

Objective To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS).Methods A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014.Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery.Twenty-one pairs (42 cases) patients were included for analysis.The t-test,x2 test or Fisher's exact probabilities was adopted,if appropriate,to compare demographics and outcomes between the 2 groups.The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons.Results After propensity score-matched analysis,the VATS group had a longer operative time ((296.9±73.6) minutes vs.(218.1±59.2) minutes,t =3.82,P=0.00),but shorter postoperative drainage time ((3.3±1.5) days vs.(2.0±3.0) days,t=-0.93,P=0.01) and hospitalization time((6.7±2.8) days vs.(12.1±8.7)days,t=-1.72,P=0.01) than that of the thoracotomy group.Perioperative complications,1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups.Conclusion For suitable patients,sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.