Single-incision Versus Multiple-incision Thoracoscopic Lobectomy and Segmentectomy

Wang, Bing‐Yen; Liu, Chao-Yu; Hsu, Po‐Kuei; Shih, Chun‐Hsing; Liu, Chia‐Chuan

doi:10.1097/sla.0000000000000712

Cited by 114 publications

(119 citation statements)

References 25 publications

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“…Wang et al (21) reported that single-incision thoracoscopic lobectomy and segmentectomy are technically feasible methods and that their perioperative outcomes are similar to those of the multiple-incision approach. Unfortunately, no study has compared single-port VATS sleeve lobectomy with the multiple approaches.…”

Section: Discussionmentioning

confidence: 99%

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

Chen

Huang

et al. 2016

J. Thorac. Dis.

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Background: Bronchial anastomosis is a key technical challenge in sleeve lobectomy, especially when using the video-assisted thoracoscopic surgery (VATS) approach. A retrospective study was conducted to evaluate the feasibility and safety of a modified bronchial anastomosis technique developed by the authors at Fujian Union Hospital.Methods: From October 2010 to October 2015, we performed 32 cases of VATS sleeve lobectomy through a three-port or single-port approach. All bronchial anastomoses were performed using modified bronchial anastomosis technique: the bronchial anastomosis was begun with an initial stitch on the posterior wall, and the bilateral quarters of the circumference were continuously sutured. The other two bilateral quarters were then similarly sutured, and the last knot was made outside the bronchial lumen.Results: All cases were completed uneventfully. No perioperative deaths or serious complications occurred.The mean operative time, bronchial anastomosis time, and blood loss volume were 271.8±67.5, 37.6±12.0 min, and 177.5±102.9 mL, respectively. The mean follow-up time was 21.0±11.7 months, and the follow-up rate was 96.9% (31/32). An electronic bronchoscope scan was performed 6 months after surgery, and a fine healing stoma was detected in all cases. No anastomotic fistula, anastomotic stenosis, or other serious postoperative anastomotic complications occurred until the end of follow-up.Conclusions: Modified bronchial anastomosis technique applied in bronchial anastomosis was safe and feasible in three-port and single-port VATS sleeve lobectomy with good short-term and long-term therapeutic results. Adequate management of the operative process and implementation of a skilled bronchial anastomosis technique could help to reduce the difficulty of VATS sleeve lobectomy.

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Section: Discussionmentioning

confidence: 99%

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

Chen

Huang

et al. 2016

J. Thorac. Dis.

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“…Other limitations of the systematic review included the variable reporting of conversions in different studies and variable grading of postoperative morbidities. Whilst most studies included conversion rates (from single port to multiportal VATS or from VATS to open thoracotomy) in their analysis of surgical outcomes, Wang and colleagues used conversion as one of their exclusion criteria for statistical analysis (22). Furthermore, some studies accounted for a learning curve period by excluding the initial patients who underwent uniportal VATS from analysis in order to exclude the learning curve (21).…”

Section: Discussionmentioning

confidence: 99%

“…Wang and colleagues noted that a randomized control trial could not be easily performed in this setting, but suggested further prospective studies in the future (22). In order to minimize patient selection bias due to the non-random allocation of treatment, three studies performed propensity-matched analyses to improve the matching of patients according to relevant prognostic factors (20)(21)(22). Other limitations of the systematic review included the variable reporting of conversions in different studies and variable grading of postoperative morbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Of the eight observational studies included for meta-analysis, one was prospective (20) and all others were retrospective in design. Wang and colleagues noted that a randomized control trial could not be easily performed in this setting, but suggested further prospective studies in the future (22). In order to minimize patient selection bias due to the non-random allocation of treatment, three studies performed propensity-matched analyses to improve the matching of patients according to relevant prognostic factors (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

“…Overall, a total of 1,850 patients were compared, including 627 patients who underwent uniportal VATS and 1,223 patients who underwent multiportal VATS. Three studies reported propensity-matched data (20)(21)(22). Two of these studies presented data from both unmatched and propensity- matched cohorts (20,22) and unmatched data from these studies is presented in Tables 1-3.…”

Section: Quantity and Quality Of Trialsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic Review and Meta-Analysis of Uniportal Versus Multiportal Video- Assisted Thoracoscopic Lobectomy for Lung Cancer

Cao

Harris

James

et al. 2017

Heart, Lung and Circulation

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The learning curve for uniportal video‐assisted thoracoscopic anatomical segmentectomy

Wan

et al. 2021

Journal of Surgical Oncology

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Objectives: The aim of this study is to evaluate the time course and caseload required to achieve proficiency by plotting the learning curve of uniportal thoracoscopic segmentectomy.Methods: We retrospectively analyzed the first 238 and 159 cases of uniportal thoracoscopic segmentectomy performed by two surgeons (A and B). The learning curves were assessed using cumulative sum analysis. Perioperative outcomes were evaluated as the learning curve developed. Two subtypes of this surgical approach, simple and complex segmentectomy, were separately analyzed.Results: Based on the learning curve, the inflection points occurred at 64 and 90 cases for surgeon A, 71 and 100 cases for surgeon B. Significantly longer operative time (p = .013), length of stay (p = .002), and drainage duration (p = .039) were observed between phase I and phase II compared to phase III for surgeon A.Operative times (p = .001) were significantly reduced for surgeon B. Furthermore, 26-28 and 52-56 cases were necessary to master the simple and complex segmentectomy, respectively.Conclusions: A total 64-71 cases were required to master uniportal thoracoscopic segmentectomy and 90-100 cases were necessary to achieve proficiency.

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Single-incision Versus Multiple-incision Thoracoscopic Lobectomy and Segmentectomy

Abstract: Single-incision thoracoscopic lobectomy and segmentectomy are feasible, and perioperative outcomes are comparable with those of the multiple-incision approach.

Cited by 114 publications

References 25 publications

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

Systematic Review and Meta-Analysis of Uniportal Versus Multiportal Video- Assisted Thoracoscopic Lobectomy for Lung Cancer

The learning curve for uniportal video‐assisted thoracoscopic anatomical segmentectomy

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