Uniportal thoracoscopic right middle lobectomy via posterior approach in 52 patients: A prospective cohort study
- VernacularTitle:单孔胸腔镜后入路右肺中叶切除术52例前瞻性队列研究
- Author:
Xiuji YAN
1
;
Hanlu ZHANG
2
;
Longqi CHEN
2
;
Yimin GU
2
;
Wenping WANG
2
Author Information
1. 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China 2. Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Uniportal video-assisted thoracoscopic surgery;
right middle lobectomy;
improvement of surgical technology
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(09):1281-1287
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the short-term surgical outcomes of the modified surgical procedure for uniportal thoracoscopic right middle lobectomy (RML). Methods In this modified approach, the incision was created at sixth or seventh intercostal space inferior to the subscapular angle. The surgeon stood on the opposite side of the operating table. The surgery was performed by serial division of the anterior oblique fissure, the vein, bronchus, artery, and horizontal fissure following the single-direction strategy. As for patients with malignant lesions, hilar and mediastinal lymph node dissection was performed. Clinical characteristics and early surgical outcomes were collected and analyzed. Results Fifty two patients were included in this study in the Department of Thoracic Surgery, West China Hospital, Sichuan University between January 2021 and June 2023. There were 20 males and 32 females at an average age of 48.0±10.5 years. No conversion or perioperative mortality was occurred. Mean surgical time was 68.1±16.8 min, mean blood loss was 16.5±4.9 mL, median chest tube duration was 2 (2-22) d and median postoperative hospital stay was 3 (3-24) d. There was no intraoperative or postoperative complication but one patient developed postoperative prolonged air leak (>5 d). Mean postoperative visual-analog scale on postoperative day 1, day 2 and day 3 was 1.5±0.8, 1.7±0.4, 0.8±0.7, respectively. Conclusion Trans-posterior-approach uniportal thoracoscopic single-direction RML is a safe, feasible, and effective procedure, which provides an appropriate direction and angle for dissection and stapling, solving the challenge of conventional uniportal RML lobectomy.
