ArticleSurgical endoscopy2026
Safety and feasibility of bilateral lung transplantation with video-assisted thoracic surgery.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Safety of Invasive Procedures During Adult Extracorporeal Membrane Oxygenation: A Systematic Review.Journal of clinical medicine · 2026Review
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11 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe clamshell incision remains the most common approach for bilateral lung transplantation because it provides excellent exposure of bilateral pleural cavities and the mediastinum. However, it is associated with significant morbidity, including sternal dehiscence and instability. Video-assisted thoracic surgery (VATS) offers a less invasive alternative. This study aimed to evaluate the feasibility, safety, and early postoperative outcomes of the VATS approach.
methodsWe retrospectively analyzed 136 patients who underwent bilateral lung transplantation with extracorporeal membrane oxygenation support between August 2017 and March 2025. Patients were categorized according to surgical approach: clamshell (n = 105) or VATS (n = 31). Perioperative outcomes, complications, and pulmonary function were compared between the two modalities.
resultsThe VATS group had a significantly shorter operative time (319 vs. 417 min., P < 0.001), less blood loss (832 vs. 2,789 mL, P < 0.001), and required fewer transfusions. Sternal wound complications and airway interventions occurred exclusively in the clamshell group. Patients in the VATS group exhibited significantly higher pulmonary function at 1 month postoperatively than did the clamshell group (forced expiratory volume in 1 s (FEV
conclusionsVATS approach for bilateral lung transplantation is feasible and safe, offering lower surgical morbidity and better pulmonary function than the conventional clamshell incision. This technique may provide distinct advantages in centers with established thoracoscopic expertise.
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