Uniportal Video-Assisted Thoracoscopic Lobectomy: Two Years of Experience

González-Rivas, Diego; Paradela, Marina; Fernández, Ricardo; Delgado, María Isabel; Fieira, Eva; Méndez, Lucía; Velasco, Carlos; Torre, Mercedes de la

doi:10.1016/j.athoracsur.2012.10.070

Cited by 304 publications

(285 citation statements)

References 19 publications

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“…Recently, uniportal thoracoscopic surgery has garnered substantial attention because the procedure is associated with less surgical wound pain, less residual paresthesia, a shorter hospital stay (5) and desirable cosmetic effects. Notably, this procedure can be applied in to most major lung resections (32). Considering the benefits of a single incision technique, combined with the minimal invasiveness that is achieved by avoiding general anesthesia, we have applied this procedure to numerous routine operations.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Tsai¹,

Lin²,

Hsu³

et al. 2017

J. Vis. Surg.

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“…VATS allows for decreased post-operative hospitalization times and decreased peri-operative pain when compared to thoracotomy (1,2). Since it was first introduced in 1998, uniportal VATS technique has been consistently refined and is now used for a variety of procedures including sub-anatomic resections, lobectomies, and other major thoracic procedures (3)(4)(5)(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).…”

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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“…Recently, GONZALES-RIVAS et al [73] have reported excellent results with a technique using a uniportal video-assisted approach for performing lobectomy: median length of stay of 3 days, complications in 14% of patients and no 30-day mortality.…”

Section: Surgery For Early Stage Lung Cancer (Stage I and Ii)mentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Uniportal Video-Assisted Thoracoscopic Lobectomy: Two Years of Experience

Cited by 304 publications

References 19 publications

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

Nonintubated uniportal thoracoscopic wedge resection for early lung cancer

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

Surgery for nonsmall cell lung cancer

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