Feasibility and Safety of Single-Port Video-Assisted Thoracic Surgery for Primary Lung Cancer

Heo, Woon; Kang, Do Kyun; Min, Ho-Ki; Jun, Hee Jae; Hwang, Youn‐Ho

doi:10.5090/kjtcs.2017.50.3.190

Cited by 15 publications

(18 citation statements)

References 14 publications

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“…In the present study, the conversion rate from uniportal VATS to multiportal VATS was 5.3% (N=7); in other studies, conversion to multi-portal VATS or open thoracotomy has ranged from 0% to 17.8%, depending on the surgeons' experience and surgical plan (4,17,32,(36)(37)(38)(39). The reason for conversion is generally attributed to dense pleural adhesion, bleeding, calcified hilar lymph nodes, or unstable patient condition.…”

Section: Discussionmentioning

confidence: 88%

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Tsai¹,

Lin²,

Hsu³

et al. 2017

J. Vis. Surg.

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Section: Discussionmentioning

confidence: 88%

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Tsai¹,

Lin²,

Hsu³

et al. 2017

J. Vis. Surg.

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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: 83%

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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“…Firstly, only four included studies are prospective in design, and the majority is retrospective which is of lower quality and inevitably introduce potential biases to the results.. U-VATS emerges as a novel surgical technique, so investigators have a propensity to publish positive outcomes to demonstrate the superiority or, at least, feasibility of U-VATS. Besides, due to the limited operating space and the narrow surgical field, U-VATS is usually performed in experienced hands [7,18,19,21,24] Consequently, the equivalent results between two approaches reported in this meta-analysis should be quite conservative. Secondly, our meta-analysis showed a high heterogeneity in the comparative outcomes (except conversion rates and number of resected lymph nodes).…”

Section: Discussionmentioning

confidence: 98%

Uniportal versus multiportal video-assisted thoracoscopic surgery for non-small cell lung cancer: a meta-analysis

Yan¹,

Han²,

Zhang³

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 to minimizing the incisions, 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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Feasibility and Safety of Single-Port Video-Assisted Thoracic Surgery for Primary Lung Cancer

Cited by 15 publications

References 14 publications

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

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

Uniportal versus multiportal video-assisted thoracoscopic surgery for non-small cell lung cancer: a meta-analysis

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