Comparison of Postoperative Pain and Recovery between Single-Port and Two-Port Thoracoscopic Lobectomy for Lung Cancer

Liu, Zhengcheng; Yang, Rusong; Shao, Feng

doi:10.1055/s-0038-1666835

Cited by 24 publications

(29 citation statements)

References 15 publications

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“…Some of our included studies did not control the same surgeon to perform these two procedures, which would bring potential bias to the results of our study. [7,20,21,23,26] Our meta-analysis showed a high heterogeneity in the comparative outcomes (except conversion rates and number of resected lymph nodes). Several included studies mentioned the learning curve for U-VATS, and it might cause high heterogeneity.…”

Section: Discussionmentioning

confidence: 82%

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Yan

Han

Zhang

et al. 2020

Preprint

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Background Uniportal video-assisted thoracoscopic surgery (U-VATS) has recently emerged as an alternative procedure for non-small cell lung cancer (NSCLC); however, whether U-VATS has advantages over multiportal VATS (M-VATS) remains unknown. Methods We performed a systematic review of two databases (Pubmed and Web of Science) to search comparative studies of U-VATS and M-VATS anatomical pulmonary resection for NSCLC. Parameters of continuous variables (operative time, blood loss, number of resected lymph nodes, drainage duration, length of postoperative stay and pain in postoperative day 1(POD1)) or categorical variables (conversion rates) were retrieved to estimate the comparitiveoutcomes. A subgroup analysis stratified by study type (propensity-matched analysis& randomized-controlled trial versus non-propensity matched analysis) was performed. Result A total of 19 studies with 3809 patients were included in this meta-analysis. U-VATS was performed on 1747 patients, whereas the other 2062 patients underwent M-VATS. This meta-analysis showed that there was no significant difference in operative time (U-VATS: 146.48±55.07min versus M-VATS: 171.70±79.40min, P=0.81), blood loss (74.49±109.03mL versus 95.48±133.67mL, P=0.18), resected lymph nodes (17.28±9.46 versus 18.31±10.17, P=0.62), conversion rate (6.18% versus 4.34%, P=0.14), drainage duration (3.90±2.94 days versus 4.44±3.12 days, p=0.09), length of postoperative stay (6.16±4.40 days versus 6.45±4.80 days, P=0.22), and pain in POD1 (3.94±1.68 versus 3.59±2.76, p=0.07). Subgroup analysis showed the value of PSM&RCT group consistency with overall value. Conclusion This up-to-date meta-analysis shows that the perioperative outcomes of U-VATS and M-VATS anatomical pulmonary resection are equivalent. In addition, the differences in long-term outcomes of these two approaches are still unclear. Thoracic surgeons should pay more emphasize on providing high-quality and personalized surgical care for patients, to improve the survival ultimately.

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Section: Discussionmentioning

confidence: 82%

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Yan

Han

Zhang

et al. 2020

Preprint

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“…After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups (Table 1). In tubeless group, the mean diameter of the lesions was 9.8 mm (7)(8)(9)(10)(11)(12)(13)(14). The postoperative VAS score was signi cantly lower in tubeless group than in drainage group in postoperative day 1 and 3.…”

Section: Resultsmentioning

confidence: 90%

Tubeless Uniportal Thoracoscopic Wedge Resection with Modified Air Leak Test and Chest Tube Drainage

Liu

Yang

Sun

2020

Preprint

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Background: To investigate whether tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage has better short-term outcomes than non-intubated approach with chest tube drainage.Methods: Data were collected retrospectively from January 2017 and December 2019. Tubeless group included 55 patients with pulmonary nodules underwent tubeless uniportal thoracoscopic wedge resection, 211 patients underwent non-intubated uniportal thoracoscopic wedge resection with chest tube drainage were included in drainage group. Peri-operative outcomes between two groups were compared. Results: After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups. Mean incision size was 3 cm in both group. Mean operative time was 59.3 minutes in tubeless group and 52.8 minutes in drainage group. The detectable mean lowest SpO2 and mean peak EtCO2 during operation was acceptable in both groups. Conversion to intubated ventilation or thoracotomy was not required. No patient failed the air leak test and did not undergo a tubeless procedure. Mean postoperative hospital stay was 1.5 days in tubeless group and 2.5 days in drainage group. Residual pneumothorax or subcutaneous emphysema was not frequent and mild in tubeless group. Side effects were rare and mild, including cough and hemoptysis. No re-intervention or readmission occurred. The postoperative VAS score was significantly lower in tubeless group.Conclusions: Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage is feasible and safe for selected patients with peripheral pulmonary nodules, it might reduce post-operation pain and lead to faster recovery.

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“…In tubeless group, the mean diameter of the lesions was 9.8 mm (7)(8)(9)(10)(11)(12)(13)(14). The locations of PPN included right upper lobe, right lower lobe, left upper lobe and left lower lobe.…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies showed that patients who underwent non-intubated surgery correlated with shorter postoperative hospital stays and postoperative fasting time, they also exhibited a trend toward lower cardiovascular complication rates (1.45% vs 2.69%) and respiratory complication rates (8.23% vs 11.18%) (8,9) . Compared with multiportal VATS, uniportal VATS might reduce post-operation pain and lead to faster recovery (10) . Uni-portal VATS only invades a single intercostal region, thoracic muscles could also be spared, leading to less intercostal nerve disorder and less postoperative pain (11) .…”

Section: Discussionmentioning

confidence: 99%

Tubeless Uniportal Thoracoscopic Wedge Resection with Modified Air Leak Test and Chest Tube Drainage

Liu

Yang

Sun

2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: To investigate whether tubeless uniportal thoracoscopic wedge resection has better short-term outcomes than non-intubated approach with chest tube drainage.Methods: Data were collected retrospectively from January 2017 and December 2019. Tubeless group included 55 patients with pulmonary nodules underwent tubeless uniportal thoracoscopic wedge resection, 211 patients underwent non-intubated uniportal thoracoscopic wedge resection with chest tube drainage were included in drainage group. Perioperative outcomes between two groups were compared. Results: After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups. Mean incision size was 3 cm in both group. Mean operative time was 59.3 minutes in tubeless group and 52.8 minutes in drainage group. The detectable mean lowest SpO2 and mean peak EtCO2 during operation was acceptable in both groups. Conversion to intubated ventilation or thoracotomy was not required. No patient failed the air leak test and did not undergo a tubeless procedure. Mean postoperative hospital stay was 1.5 days in tubeless group and 2.5 days in drainage group. Residual pneumothorax or subcutaneous emphysema was not frequent and mild in tubeless group. The postoperative pain VAS score was pain score was significantly lower in tubeless group in post-operative day 1 and 3. Side effects were rare and mild, including cough and hemoptysis. No reintervention or readmission occurred.Conclusions: Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage is feasible and safe for selected patients with peripheral pulmonary nodules, it might reduce post-operation pain and lead to faster recovery.

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Comparison of Postoperative Pain and Recovery between Single-Port and Two-Port Thoracoscopic Lobectomy for Lung Cancer

Abstract: Compared with the multiport approach, SP VATS lobectomy might reduce postoperative pain and lead to faster recovery.

Cited by 24 publications

References 15 publications

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Tubeless Uniportal Thoracoscopic Wedge Resection with Modified Air Leak Test and Chest Tube Drainage

Tubeless Uniportal Thoracoscopic Wedge Resection with Modified Air Leak Test and Chest Tube Drainage

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