Xueying Yang1, Linlin Wang2,3, Chenxi Zhang2, Danyang Zhao2, Yao Lu2, Zelong Wang2. 1. Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, No. 4, ChongShan East Road, HuangGu District, Shenyang, 110032, Liaoning, People's Republic of China. yangxy@sj-hospital.org. 2. Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, No. 4, ChongShan East Road, HuangGu District, Shenyang, 110032, Liaoning, People's Republic of China. 3. Department of Thoracic Surgery, Shenyang Chest Hospital, No. 11, Beihai Street, Dadong District, Shenyang, 110044, Liaoning, People's Republic of China.
Abstract
BACKGROUND: Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy has emerged as a promising and exciting approach for minimally invasive thoracic surgeries. However, nearly all reported uniportal VATS lobectomies are performed via an intercostal route, and chest wall trauma remains an issue. Here, we report the use of a novel uniportal VATS technique involving a subxiphoid route for pulmonary lobectomies. METHODS: We retrospectively analyzed perioperative data for patients who underwent subxiphoid uniportal and traditional three-port VATS lobectomies from January 2016 to January 2017 at our hospital. RESULTS: During the study period, 37 patients successively underwent subxiphoid uniportal VATS lobectomies, including three synchronous bilateral pulmonectomies; 68 patients underwent traditional three-port VATS. There were no surgical or 30-day postoperative mortalities, and no significant between-group differences were found in the number of retrieved lymph nodes, number of explored nodal stations, blood loss, drainage time, postoperative complications, or length of hospital stay. Operative time was longer in the subxiphoid uniportal VATS group than in the traditional three-port VATS group (P < 0.001). Visual analog scale (VAS) pain scores after surgery were significantly lower in the subxiphoid uniportal VATS group (P < 0.05). CONCLUSIONS: Subxiphoid uniportal VATS lobectomy is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional VATS. Moreover, this procedure is better suited for patients receiving synchronous bilateral pulmonectomy. Further long-term follow-up analyses involving more patients are ongoing. TRIAL REGISTRY NUMBER: ClinicalTrials.gov NCT03051438.
BACKGROUND: Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy has emerged as a promising and exciting approach for minimally invasive thoracic surgeries. However, nearly all reported uniportal VATS lobectomies are performed via an intercostal route, and chest wall trauma remains an issue. Here, we report the use of a novel uniportal VATS technique involving a subxiphoid route for pulmonary lobectomies. METHODS: We retrospectively analyzed perioperative data for patients who underwent subxiphoid uniportal and traditional three-port VATS lobectomies from January 2016 to January 2017 at our hospital. RESULTS: During the study period, 37 patients successively underwent subxiphoid uniportal VATS lobectomies, including three synchronous bilateral pulmonectomies; 68 patients underwent traditional three-port VATS. There were no surgical or 30-day postoperative mortalities, and no significant between-group differences were found in the number of retrieved lymph nodes, number of explored nodal stations, blood loss, drainage time, postoperative complications, or length of hospital stay. Operative time was longer in the subxiphoid uniportal VATS group than in the traditional three-port VATS group (P < 0.001). Visual analog scale (VAS) pain scores after surgery were significantly lower in the subxiphoid uniportal VATS group (P < 0.05). CONCLUSIONS: Subxiphoid uniportal VATS lobectomy is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional VATS. Moreover, this procedure is better suited for patients receiving synchronous bilateral pulmonectomy. Further long-term follow-up analyses involving more patients are ongoing. TRIAL REGISTRY NUMBER: ClinicalTrials.gov NCT03051438.
Authors: Waël C Hanna; Moira de Valence; Eshetu G Atenafu; Marcelo Cypel; Thomas K Waddell; Kazuhiro Yasufuku; Andrew Pierre; Marc De Perrot; Shaf Keshavjee; Gail E Darling Journal: Eur J Cardiothorac Surg Date: 2013-01-08 Impact factor: 4.191