Prof. Liu Lunxun was selected into American Association for Thoracic Surgery as New Member in 2018.
Lobectomy is the main surgical procedure for the treatment of lung diseases like cancer, bronchiectasis, and complications of tuberculosis. Among them, lung cancer is the most common cause of cancer-related deaths worldwide. In China, more than 300,000 newly diagnosed lung cancer patients need surgery every year. Traditionally, lobectomy was carried out through a large thoracotomy incision. Mini-invasive thoracoscopic lobectomy was initiated in the early 1990s. However, the mini-invasive lung surgery was not well promoted for a long time due to the difficulties such as the lack of mature pulmonary resection techniques, and the risk of uncontrollable massive hemorrhage through the thoracoscopic approach. In response to these issues, Professor Liu Lunxu from the Department of Thoracic Surgery, West China Hospital, Sichuan University, has created the Single-direction thoracoscopic lobectomy and a series of key techniques after more than ten years’ research. These techniques have promoted the wide application of thoracoscopic lobectomy nationwide.
The technical system of anatomic pulmonary resection was established by Dr. Liu and his team, which provided the key techniques supporting the wide application of mini-invasive lung surgery in China. The technical system included the Single-direction thoracoscopic lobectomy and the Single-direction thoracoscopic segmentectomy. Dr. Liu’s team also proposed for the first time the concept of en-bloc removing the lymph nodes during lung cancer resection, and established the "non-grasping en-bloc mediastinal lymph node dissection (MLND)" to make thoracoscopic lung cancer surgery simple and streamlined. The above-mentioned techniques shortened the operation time by 34.7%, reduced intraoperative blood loss by 65.8%, reduced surgical complications by 34.2% and surgical mortality by 64.7%. The 5-year survival rate was improved by 16% with these techniques.
The team innovated a comprehensive technique for the management of massive bleeding during thoracoscopic pulmonary resection ---- the suction-compressing angiorrhaphy technique (SCAT). With this technique, the difficulties of thoracoscopic management of vascular injury was overcome, and 88.2% of the cases were successfully treated through the mini-invasive approach without conversion to open surgery. This technique ensured the safety of thoracoscopic lung surgery, and considered as “excellent”, according to international peers.
They also created a series of comprehensive technical strategies to overcome the complicated hilar anatomy such as severe adhesion during thoracoscopic lung surgery, including prophylactically control the pulmonary artery, pre-cutting the bronchus, and co-cutting the broncho-pulmonary artery. These technical strategies enabled the application of thoracoscopic approach for some situations which were previously unable to perform the operation through mini-invasive approach. They also performed the first case series of thoracoscopic bronchovascular double sleeve lobectomy for central lung cancer, which broke through the restricted area of thoracoscopic lung surgery.
The emergence of Single-direction thoracoscopic lobectomy has been considered as “the landmark of the maturity of thoracoscopic lung cancer resection in China”. The technique was written into Surgery, a university textbook in China. Besides, the techniques of SCAT and thoracoscopic bronchovascular double sleeve lobectomy were written into Sheilds’ General Thoracic Surgery (8th Ed). Those achievements have been rewarded as the first prize of Science and Technology Progress Award of Sichuan Province in 2011, and the first prize of Chinese Medical Science and Technology Award of Chinese Medical Association (CMA) in 2013. In 2016, a survey conducted by the Chinese Society for Thoracic and Cardiovascular Surgery (CSTCVS) and the Chinese Association of Thoracic Surgeons (CATS) revealed that a total of 513 high-level hospitals (93.1%) among the 551 hospitals performing thoracoscopic lobectomy in China have adopted the technique of Single-direction thoracoscopic lobectomy, and accomplished more 160,000 cases with this technique.
