A critical analysis of single port thoracoscopic lobectomy for lung cancer patients
10.3760/cma.j.issn.1001-4497.2017.08.010
- VernacularTitle:单孔胸腔镜肺叶切除术治疗肺癌的经验与反思
- Author:
Heng WANG
1
;
Miao ZHANG
;
Wenbin WU
;
Dong LIU
;
Min LI
;
Hui ZHANG
;
Zhengqun HU
Author Information
1. 221009,东南大学附属徐州市中心医院胸外科
- Keywords:
Single port/Uniport;
Video-assisted thoracic surgery(VATS);
Lobectomy,lymph node dissection
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(8):493-498
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this study was to explore the feasibility and efficacy of single port video-assisted thora coscopic surgery(S-VATS) lobectomy for lung cancer.Methods Clinical data of consecutive 140 cases of lung cancer patients underwent S-VATS lobectomy with systematic lymph nodes dissection by the same group of surgeons between January 2013 and January 2016 was retrospectively analyzed,wbich was compared with 60 cases of multi-port VATS(M-VATS,M group) lobectomy in this period.The patients of S-VATS were divided into four groups according to the sequence of surgery(group A,B,C and D,35 cases in each group).The operation time,blood loss,number of dissected lymph nodes and nodal stations,the rate of S-VATS conversion to M-VATS or thoracotomy,postoperative complications,postoperative chest drainage as well as hospital stay were compared respectively between the five groups.Results There were no significant difference between the groups in terms of age,gender,BMI,comorbidity and T staging(PP ＞ 0.05).No one was converted to thoracotomy,and all of the sur gical specimens were negative (R0).Besides,the operation time of group A[(200.3 ± 46.3) min] was noticeably longer than that in group B [(170.9 ± 27.7) min],group C [(154.6 ± 25.0) min],group D [(142.6 ± 32.8) min] and group M [(137.3 ± 27.7) min] (P ＜ 0.05).Besides,the operation time of group B was longer than group D and M (P ＜ 0.05) while the operation time of group C was longer than group M(P =0.026),and there was no significant difference between group D and M (P =0.996).In addition,the blood loss in group A [(304.3 ± 119.0) ml] was significantly more than that of group B [(282.9 ±89.1)ml],group C[(232.9 ±82.2)ml],group D[(202.8 ±72.7)m1] and group M[(200.0 ±70.7)ml] (P ＜ 0.05) whilst the blood loss of group B was markedly more than that of group D and M (P ＜ 0.05),and no significant difference was indicated between group C,D and M(P ＞ 0.05).Moreover,there were 6 cases of blood vessel injury and 7 cases conversion to multi-port VATS in group A,which was evidently more than the other groups(P ＜ 0.05).Furthermore,the pain score of group A was remarkably higher than the other groups (P ＜ 0.05).However,the number of dissected lymph nodes,postoperative complications and chest drainage and hospital stay were similar among all the groups (P ＞ 0.05).Conclusion S-VATS lobectomy for treatment of lung cancer is feasible and effective with learning curve of nearly 70 cases,but it does not demonstrate any advantage compared with M-VATS.
