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OBJECTIVES: Pulmonary sequestration is a rare congenital malformation, and part of its treatment requires the removal of the aberrant artery by surgical means. MATERIALS AND METHODS: Five patients treated at Military Hospital 103 - Department of Thoracic Disease were diagnosed with PS via CT scan, MS-CT, and DSA, and histopathological data were evaluated retrospectively between January and December 2019. RESULTS: In all patients, surgery is the preferred option, with two cases of video-assisted thoracoscopic surgery (one lobectomy and one wedge resection), and three cases of hybrid video-assisted thoracoscopic surgery (adhesive inflammation was observed, the bronchus is challenging to reveal, to resect, and tend to bleed when resecting). The average length of stay following surgery is 11.6 ± 8.1 days. The mean duration of postoperative follow-up is 13.8 ± 3.3 months, all patients had a good quality of life, and no respiratory problems such as hemoptysis or pneumonia were detected. CONCLUSION: The excellent outcomes obtained in all patients in our study during the follow-up period (13.8 ± 3.3 months) established the appropriate indication and treatment. However, these are preliminary findings; a longer study period with a larger sample size is required to draw more valid conclusions.

Nam Nguyen Van,1 Pham Ngoc Hung,2,3 Le Tien Dung,4 Le Viet Anh,1 Dinh Cong Pho,5 Bui Dang The Anh,2 Vu Anh Hai1 1Department of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Training, Vietnam Military Medical University, Hanoi, Vietnam; 4Department of Thoracic Surgery, Phạm Ngá»c Thạch Hospital, Ho Chi Minh City, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Vu Anh HaiDepartment of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Ha Dong District, Hanoi, VietnamTel +84986112345Email vuanhhai.ncs@gmail.comBackground: Mid-term outcomes of video-assisted thoracoscopic surgery (VATS) lobectomy for early stage non-small cell lung cancer (NSCLC) in Vietnam should be evaluated and discussed.Methods: This prospective descriptive study was conducted on 94 patients with NSCLC under stages I–IIA who were treated with VATS from November 2011 to July 2014.Results: The median patient age was 55.5 ± 10.8 years. The rate of successful VATS for NSCLC treatment was 98.9%, and the conversion rate (from VATS to thoracotomy) was 1.1%. The operative time was 143.8 ± 38.9 minutes, the amount of blood loss was 194.8 ± 150.5 mL, and the postoperative complication rate was 10.6%. The ICU length stay was 2.8 ± 1.0 days, and the postoperative hospital length stay was 7.7 ± 2.1 days. Among the 89 patients with successful follow-up, one (1.1%) had a recurrent tumor, and ten (11.8%) had metastasis. The 1- and 2-year relative survival rates were 95.9% (3 deaths) and 80.8% (9 deaths), respectively.Conclusion: VATS treatment for early stage NSCLC is an effective method with safe outcomes. The mid-term outcomes were acceptable with 1- and 2-year relative survival rates of 95.9% and 80.8%, respectively.Keywords: video-assisted thoracoscopic surgery, VATS, non-small cell lung cancer, NSCLC, early-stage, short-term outcomes, mid-term outcomes

Nguyen Truong Giang,1 Nguyen Van Nam,1 Nguyen Ngoc Trung,1 Le Viet Anh,1 Nguyen Manh Cuong,2 Ngo Van Dinh,2 Dinh Cong Pho,2 Phillip Geiger,3 Nguyen Trung Kien2 1Department of Cardiothoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Anesthesiology, Perioperative, and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, VA, USA Background: Paravertebral block has been proven to be an efficient method to provide post-thoracotomy pain management. This study aimed to compare patient-controlled paravertebral analgesia (PCPA) and intravenous patient-controlled analgesia (IVPCA) in terms of analgesic efficiency, respiratory function, and adverse effects after video-assisted thoracoscopic surgery (VATS) lobectomy.Patients and methods: The prospective randomized trial study was carried out on 60 patients who underwent VATS lobectomy (randomly allocated 30 patients in each group). In the PCPA group, an initial dose of 0.3 mL/kg of 0.125% bupivacaine with fentanyl 2 µg/mL was administered, followed by a 3 mL/h continuous infusion with patient-controlled analgesia (2 mL bolus, 10-minute lockout interval, 25 mL/4 h limit). In the IVPCA group with morphine 1 mg/mL solution, an infusion device was programmed to deliver a 1.0 mL demand bolus with no basal infusion rate, with a 10-minute lockout interval and a maximum of 20 mL/4 h period. Postoperative pain was assessed by visual analog scale at rest and on coughing. Arterial blood gas and spirometry were monitored and recorded for the first 3 postoperative days. Side effects to include were also recorded.Results: The PCPA group had statistically significant lower pain scores (P<0.0001) at rest at all times. Lower pain scores on coughing were statistically significant in PCPA group in the first 4 hours. Postoperative spirometry showed that both the groups had comparable recovery trajectories for their pulmonary function. Arterial blood gas analysis showed pH and PaCO2 were in a normal range in both the groups. The incidence of headache was higher in the IVPCA group (13.3% vs 0%; P=0.038).Conclusion: PCPA effectively managed pain after VATS lobectomy, with lower pain scores, similar respiratory function, and fewer side effects than standard IVPCA treatment. Keywords: patient-controlled paravertebral analgesia, PCPA, intravenous patient controlled analgesia, IVPCA, video-assisted thoracoscopic surgery, VATS

BACKGROUND: Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear. AIM: This study was undertaken to specifically analyze the preoperative factor affecting to LVRS. METHODS: The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale). RESULTS: Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆ CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031). CONCLUSION: Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.