short-term efficacy of uniportal versus three-port video-assisted thoracoscopic segmentectomy: A retrospective cohort study in a single center
- VernacularTitle:单孔与三孔电视辅助胸腔镜肺段切除术近期疗效比较的单中心回顾性队列研究
- Author:
Miao ZHANG
1
,
2
;
Hao ZHANG
3
;
Wenbin WU
4
;
Tian ZHAO
4
;
Weigang CHEN
4
;
Hui ZHANG
4
Author Information
1. . Department of Thoracic Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004, Jiangsu, P. R. China
2. 2.Department of Cardiothoracic Surgery, Affiliated Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, Jiangsu, P. R. China
3. Department of Thoracic Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004, Jiangsu, P. R. China
4. Department of Cardiothoracic Surgery, Affiliated Xuzhou Clinical College of Xuzhou Medical University, Xuzhou Central Hospital, Xuzhou, 221009, Jiangsu, P. R. China
- Publication Type:Journal Article
- Keywords:
Single-direction;
uniportal;
video-assisted thoracoscopic surgery (VATS);
anatomical pulmonary resection;
segmentectomy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(10):1303-1312
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the safety and short-term efficacy of uniportal and three-port video-assisted thoracoscopic surgery (VATS) anatomical segmentectomy for pulmonary nodules. Methods The clinical data of 225 patients with consecutive VATS anatomic segmentectomy by the same surgeon in Xuzhou Central Hospital between December 2019 and February 2022 was retrospectively reviewed. There were 85 males and 140 females with an average age of 57.3±11.6 years. These patients were divided into an uniportal VATS group (128 patients) and a three-port VATS group (97 patients) according to the surgical procedures. Single-direction anatomical procedure was utilized in the uniportal VATS group. The operation time, blood loss during the surgery, number of dissected lymph nodes, duration and volume of chest drainage, incidence of complications, and postoperative hospital stay of the two groups were compared. Results There was no conversion to thoracotomy, addition of surgical ports, or mortality in this cohort, with tumor-negative surgical margins. The postoperative pathological staining confirmed 2 (0.9%) patients of lymph node metastasis (pN1) and 4 (1.8%) patients of adenocarcinoma with micropapillary component. As compared with the three-port VATS group, patients in the uniportal VATS group had shorter operation time (115.6±54.7 min vs. 141.5±62.8 min, P=0.001), less intraoperative blood loss (77.2±49.6 mL vs. 96.9±98.1 mL, P=0.050), less total thoracic drainage [394.0 (258.8, 580.0) mL vs. 530.0 (335.0, 817.5) mL, P=0.010], and shorter postoperative hospital stay (7.7±3.7 d vs. 8.7±3.5 d, P=0.031). Both groups showed similar stations and numbers of dissected lymph nodes, incidence of operation-related complications, duration of chest tube drainage, and the drainage volume in the first and second postoperative days (P>0.05). No tumor recurrence or metastasis was recorded in this cohort during the follow-up of 11 (1-26) months. Conclusion Single-direction uniportal VATS anatomical segmentectomy is safe and feasible for the treatment of pulmonary nodules, with better short-term efficacy as compared with the three-port VATS procedure, including shorter operation time, less intraoperative blood loss and thoracic drainage. However, further studies are needed to elucidate the precise indications of segmentectomy for lung cancer.
