Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study

McElnay, Philip; Molyneux, M.; Krishnadas, Rakesh; Batchelor, Tim; West, Douglas; Casali, Gianluca

doi:10.1093/ejcts/ezu324

Cited by 71 publications

(62 citation statements)

References 21 publications

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“…They concluded that uniportal VATS lobectomy does not present better postoperative outcomes (postoperative pain, delay in removing the paravertebral catheter and the chest drain, the duration of postoperative hospital stay, postoperative complications and the operative or 30-day mortality) than other VATS lobectomy techniques. These conclusions confirm the results previously described by McElnay et al (11) whose observational study demonstrated once again the feasibility of the procedure, but did not find differences in terms of pain or recovery between SP-VATS and VATS.…”

Section: A Greater Quality Of Clinical Evidence Is Neededsupporting

confidence: 92%

A greater quality of clinical evidence is needed

Jiménez

Hernández

2017

J. Thorac. Dis.

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Section: A Greater Quality Of Clinical Evidence Is Neededsupporting

confidence: 92%

A greater quality of clinical evidence is needed

Jiménez

Hernández

2017

J. Thorac. Dis.

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“…Results of performing this procedure can be found in other articles in this issue and elsewhere in the literature (5,6). It must be acknowledged that at the time of this writing, there is very little clinical data showing a significant clinical advantage for uniportal VATS when performing lobectomy (19,20). However, there is sufficient evidence that the approach is safe (5,(12)(13)(14)19,20).…”

Section: Commentsmentioning

confidence: 99%

“…It must be acknowledged that at the time of this writing, there is very little clinical data showing a significant clinical advantage for uniportal VATS when performing lobectomy (19,20). However, there is sufficient evidence that the approach is safe (5,(12)(13)(14)19,20). This means that VATS surgeons can safely learn and practice uniportal lobectomy, hopefully accumulating the clinical evidence that will ultimately show the real benefits of uniportal VATS in our specialty.…”

Section: Commentsmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic lobectomy

Sihoe

2016

Ann. Cardiothorac. Surg.

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Uniportal video assisted thoracic surgery (VATS) has become one of the most exciting new developments in minimally invasive thoracic surgery in recent years. While the debate over its purported advantages continues, this chapter instead focuses on the technical aspects of performing a lobectomy via the uniportal approach. Using clear medical illustrations to show how each step is performed, the key tips and tricks are laid out for the beginner hoping to learn the technique.

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“…Though a recent randomized study attempted to address this issue, there was considerable variation in methodology, particularly in the surgical technique used (10). Another observational study failed to show an appreciable difference in pain when comparing uniportal lobectomy to standard VATS technique, though the study was done as a non-inferiority report and included only 15 patients in the uniportal arm (11).…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery (VATS) technique is associated with decreased narcotic usage over traditional VATS lobectomy

et al. 2017

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Background: Uniportal video-assisted thoracoscopic surgery (VATS) is gaining popularity internationally, but remains an uncommon practice in the United States. One proposed benefit is a decrease in narcotic usage and peri-operative pain when compared to traditional multiple incision VATS. The purpose of this study was to determine the post-operative narcotic usage between patients undergoing anatomic lobectomy via traditional VATS as compared to patients undergoing uniportal VATS.Methods: All consecutive patients undergoing anatomic lobectomy for presumed malignancy by a single surgeon at an academic medical institution were recorded between July 2013 and September 2015. Patients were excluded if they were narcotic dependent prior to the operation, if they had an epidural catheter placed, or if they were under 18 years of age. All narcotics were converted to oral morphine equivalents (OMEq) using standard formulas.Results: Data were collected on 84 patients. There was no difference between groups with regard to age, gender, tumor size, length of stay, or duration of post-operative thoracostomy. The groups had a similar rate of complications including post-operative atrial fibrillation and need for prolonged thoracostomy. Patients undergoing uniportal VATS had significantly lower narcotic usage in the recovery room, and on postoperative days 1 and 2. In addition, the total narcotic usage during their inpatient stay was significantly lower for patients undergoing uniportal VATS.Conclusions: Uniportal VATS is a safe and effective strategy for the surgical management of benign and malignant lung disease. In patients undergoing anatomic lobectomy, there was an association with significantly less post-operative narcotic usage in patients undergoing uniportal VATS when compared to traditional VATS. This emerging technology may benefit patients by allowing less narcotic usage during their post-operative hospitalization. and other major thoracic procedures (3-6). Though the popularity of uniportal VATS continues to grow, it is not without significant detraction and the debate on its efficacy and proper use continues (7). A recent metaanalysis demonstrated favorable outcomes when comparing multiport with uniportal VATS with regard to postoperative hospitalization, thoracostomy drainage duration, and morbidity (8).Uniportal technique offers several potential benefits, one of which is decreased postoperative pain and resultant narcotic usage. In patients undergoing thoracoscopy for pneumothorax, uniportal technique was associated with decreased postoperative pain (9). Though a recent randomized study attempted to address this issue, there was considerable variation in methodology, particularly in the surgical technique used (10). Another observational study failed to show an appreciable difference in pain when comparing uniportal lobectomy to standard VATS technique, though the study was done as a non-inferiority report and included only 15 patients in the uniportal arm (11).In addition, the previous studies have largely us...

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Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study

Cited by 71 publications

References 21 publications

A greater quality of clinical evidence is needed

A greater quality of clinical evidence is needed

Uniportal video-assisted thoracoscopic lobectomy

Uniportal video-assisted thoracoscopic surgery (VATS) technique is associated with decreased narcotic usage over traditional VATS lobectomy

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