Single- versus multiple-port thoracoscopic lobectomy for lung cancer: a propensity-matched study

Shen, Yaxing; Wang, Hao; Feng, Mingxiang; Xi, Yong; Tan, Liang; Wang, Qun

doi:10.1093/ejcts/ezv358

Cited by 84 publications

(112 citation statements)

References 22 publications

(23 reference statements)

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“…Uniportal VATS is quickly gaining popularity as a surgical approach and has been rapidly adopted across Europe and Asia (11)(12)(13)(14). In a recently published propensity-matched analysis, uniportal VATS lobectomy was shown to be equivalent to multiport thoracoscopic lobectomy regarding most perioperative outcomes with the possible added advantages of better pain control and earlier patient mobilization (15). Likewise, decreased duration of chest tube drainage and shorter hospital stay after uniportal thoracic surgery have also been shown in some studies (16,17).…”

Section: Introductionmentioning

confidence: 90%

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Drevet¹,

Figueroa²

2016

Ann. Cardiothorac. Surg.

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Background: Video-assisted thoracoscopic surgery (VATS) using a single incision (uniportal) may result in better pain control, earlier mobilization and shorter hospital stays. Here, we review the safety and efficiency of our initial experience with uniportal VATS and evaluate our learning curve. Methods:We conducted a retrospective review of uniportal VATS using a prospectively maintained departmental database and analyzed patients who had undergone a lung anatomic resection separately from patients who underwent other resections. To assess the learning curve, we compared the first 10 months of the study period with the second 10 months. Conclusions: Uniportal VATS was safe and feasible for both standard and complex pulmonary resections.However, when used for pulmonary anatomic resections, uniportal VATS entails a steep learning curve.

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Section: Introductionmentioning

confidence: 90%

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Drevet¹,

Figueroa²

2016

Ann. Cardiothorac. Surg.

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“…There is also evidence that less invasive surgery increases both the body image and cosmesis which was shown in a randomized controlled trial comparing laparoscopic single-port versus three-port appendectomy (17). Currently, similar trends for reducing the extent of surgical trauma are observed in thoracic surgery where thoracoscopic lobectomy using the singleport procedure was recently introduced (18,19). Moreover, natural orifice transluminal endoscopic surgery (NOTES) was evaluated by different groups to develop new access routes for thoracic surgery.…”

Section: Discussionmentioning

confidence: 96%

Transoral endoscopic mediastinal surgery (TOEMS)—results of a first clinical study for scarless mediastinal lymph node biopsies

et al. 2016

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Background: Video-assisted mediastinoscopy (VAM) represents the standard procedure for mediastinal lymph node biopsies. This operation results in a scar at prominent position at the anterior neck. Since there is a trend to less invasive procedures, natural orifice transluminal endoscopic surgery (NOTES) was introduced to different fields of surgery. Based on NOTES we developed a new approach for mediastinoscopy: transoral endoscopic mediastinal surgery (TOEMS). In previous studies using human cadavers and living pigs the feasibility of TOEMS was shown. It was unclear whether TOEMS could be safely applied in patients requiring mediastinal lymph node biopsies.Methods: We conducted a clinical phase I study recruiting ten patients with unclear mediastinal lymphadenopathy not resolved by prior bronchoscopy. All patients underwent TOEMS for mediastinal lymph node biopsy. The duration of the procedure and complications were monitored. In addition, all patients were examined for pain, swallowing dysfunction and sensation disturbance.Results: TOEMS was accomplished in eight patients. In two patients operation was converted to VAM due to technical problems. Mediastinal lymph nodes were dissected in all patients who finished with TOEMS. On average, two separate lymph stations were reached by TOEMS. Duration of the procedure was 159±22 min.Permanent palsy of the right recurrent laryngeal nerve was noticed in one patient postoperatively.Conclusions: This is the first report for a human application of NOTES in thoracic surgery. In fact, transoral endoscopic surgery seems to be a feasible approach for mediastinal lymph node biopsies.Further studies are needed to show whether this procedure has an advantage over VAM in terms of pain, complications and accessibility of mediastinal lymph node stations.

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“…Once surgeons have acquired the skills required for the U-VATS procedure, U-VATS allows blood vessels and bronchi to be dealt with faster and easier compared with conventional M-VATS in patients with favorable lobation. Actually, it has been reported that the time required for lobectomy was shorter and that for lymphadenectomy was longer in U-VATS compared with M-VATS (12). Regarding lymphadenectomy, it is necessary to devise techniques for right-and left-sided subcarinal lymph node dissection, and this may take time.…”

Section: What Are the Advantages Of U-vats?mentioning

confidence: 99%

For which thoracic operation is U-VATS superior?

2017

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Single- versus multiple-port thoracoscopic lobectomy for lung cancer: a propensity-matched study

Abstract: In comparison with conventional VATS, SP VATS lobectomy showed better safety and efficacy in the surgical resection of NSCLCs. Further studies based on larger populations and better methodology are required to determine its further benefits towards patients.

Cited by 84 publications

References 22 publications

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Uniportal video-assisted thoracoscopic surgery: safety, efficacy and learning curve during the first 250 cases in Quebec, Canada

Transoral endoscopic mediastinal surgery (TOEMS)—results of a first clinical study for scarless mediastinal lymph node biopsies

For which thoracic operation is U-VATS superior?

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