Wide exposure in uniportal video-assisted thoracoscopic surgery for radical resection of lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

RAO Sunyin , HUANG Yunchao ,  YE Lianhua , RUAN Wenpeng , CHEN Ya , YANG Jichen

The First Department of Thoracic Surgery, Cancer Hospital, Kunming Medical University, Kunming, 650105, P.R.China;

Corresponding author：

YE Lianhua, Email: Lhye1204@aliyun.com

Keywords：

Uniportal surgery; video-assisted thoracoscopic surgery; lung cancer; wide exposure; mediastinal lymphadenectomy

DOI：

10.7507/1007-4848.201806049

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the advantage of the concept of wide exposure in uniportal video-assisted thoracoscopic surgery (uniportal-VATS) for radical resection of lung cancer and assess its safety and feasibility. Methods Clinical data of 255 patients (110 males and 145 females, a mean age of 54.3±7.9 years) with non-small cell lung cancer (NSCLC) who received wide exposure in uniportal-VATS or three portal VATS (3P-VATS) during August 2017 to March 2018 were retrospectively analyzed. There were 153 patients (67 males and 86 females, a mean age of 56.1±8.5 years) in the uniportal-VATS group and 102 patients (43 males and 59 femals, a mean age of 54.4±7.4 years) in the 3P-VATS group. The clinical effects were compared between the two groups. Results There was no statistical difference in the operation time between the uniportal-VATS and 3P-VATS (135.0±45.6 min vs. 142.0±39.5 min, P>0.05). The overall number of dissected stations (6.9±1.0) and LNs (14.5±3.0) in the uniportal-VATS group were similar with those in the 3P-VATS group (7.1±1.0, 15.1±1.7). The dissected stations of N2 LNs (uniportal-VATS: 4.1±1.7, 3P-VATS: 3.9±0.8) and number of dissected N2 LNs (uniportal-VATS: 8.0±0.9, 3P-VATS: 7.8±1.1) were both similar between the two groups. The duration of postoperative tube drainage and postoperative hospital stay of uniportal-VATS group (3.5±1.8 d and 7.2±0.9 d) were much shorter than those of 3P-VATS group (4.0±1.3 d and 8.8±2.0 d). No significant difference was found in incidence of postoperative complication between the two groups except that the incidence of subcutaneous emphysema in the uniportal-VATS group was much lower. There was no perioperative death in the two groups. Conclusion The concept of wide exposure in uniportal-VATS can meet the requirment of radical resection and it is a safe and valid method which can be used for radical resection of lung cancer.

Citation： RAO Sunyin, HUANG Yunchao, YE Lianhua, RUAN Wenpeng, CHEN Ya, YANG Jichen. Wide exposure in uniportal video-assisted thoracoscopic surgery for radical resection of lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(4): 374-378. doi: 10.7507/1007-4848.201806049 Copy

1.	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2.	周清华, 范亚光, 王颖, 等. 中国肺部结节分类、诊断与治疗指南 (2016 年版). 中国肺癌杂志, 2016, 19(12): 793-798.
3.	Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
4.	Yang HC, Noh D. Single incision thoracoscopic lobectomy through a 2.5 cm skin incision. J Thorac Dis, 2015, 7(5): E122-E125.
5.	Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis, 2014, 6(1): 14-21.
6.	赵光强, 黄云超, 陈小波, 等. 快速康复外科在肺癌手术中的应用研究. 中国肺癌杂志, 2010, 13(2): 102-106.
7.	Liu C, Pu Q, Guo C, et al. Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery. BMC Surg, 2015, 15: 38.
8.	郝志鹏, 蔡奕欣, 付圣灵, 等. 纵隔淋巴结模块化清扫在单孔胸腔镜肺癌根治术中的应用. 中国胸心血管外科临床杂志, 2017, 24(7): 527-532.
9.	D’Amico TA, Niland J, Mamet R, et al. Efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy. Ann Thorac Surg, 2011, 92(1): 226-231.
10.	霍云奎, 张雍偲, 闫晓亮, 等. 胸腔镜肺叶切除在Ⅰ/Ⅱa 期非小细胞肺癌治疗中的临床应用. 临床医学研究与实践, 2017, 24(3): 116-117.
11.	Kozian A, Schilling T, Fredén F, et al. One-lung ventilation induces hyperperfusion and alveolar damage in the ventilated lung: an experimental study. Br J Anaesth, 2008, 100(4): 549-559.
12.	蓝岚. 单肺通气时间对肺损伤的影响. 南方医科大学, 2012.
13.	郑鑫林, 夏学阳, 张金周, 等. 胸腔镜下肺段切除与肺叶切除治疗临床Ⅰ期非小细胞肺癌疗效对比的 Meta 分析. 中国癌症杂志, 2016, 26(10): 854-860.
14.	Saito H, Konno H, Atari M, et al. Management of intersegmental plane on pulmonary segmentectomy concerning postoperative complications. Ann Thorac Surg, 2017, 103(6): 1773-1780.
15.	Okada M, Mimae T, Tsutani Y, et al. Segmentectomy versus lobectomy for clinical stage ⅠA lung adenocarcinoma. Ann Cardiothorac Surg, 2014, 3(2): 153-159.
16.	马少华, 闫天生, 王可毅, 等. 完全胸腔镜下解剖性肺段切除术治疗早期肺癌的体会. 中国肺癌杂志, 2018, 21(2): 99-103.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2. 周清华, 范亚光, 王颖, 等. 中国肺部结节分类、诊断与治疗指南 (2016 年版). 中国肺癌杂志, 2016, 19(12): 793-798.
3. Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
4. Yang HC, Noh D. Single incision thoracoscopic lobectomy through a 2.5 cm skin incision. J Thorac Dis, 2015, 7(5): E122-E125.
5. Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis, 2014, 6(1): 14-21.
6. 赵光强, 黄云超, 陈小波, 等. 快速康复外科在肺癌手术中的应用研究. 中国肺癌杂志, 2010, 13(2): 102-106.
7. Liu C, Pu Q, Guo C, et al. Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery. BMC Surg, 2015, 15: 38.
8. 郝志鹏, 蔡奕欣, 付圣灵, 等. 纵隔淋巴结模块化清扫在单孔胸腔镜肺癌根治术中的应用. 中国胸心血管外科临床杂志, 2017, 24(7): 527-532.
9. D’Amico TA, Niland J, Mamet R, et al. Efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy. Ann Thorac Surg, 2011, 92(1): 226-231.
10. 霍云奎, 张雍偲, 闫晓亮, 等. 胸腔镜肺叶切除在Ⅰ/Ⅱa 期非小细胞肺癌治疗中的临床应用. 临床医学研究与实践, 2017, 24(3): 116-117.
11. Kozian A, Schilling T, Fredén F, et al. One-lung ventilation induces hyperperfusion and alveolar damage in the ventilated lung: an experimental study. Br J Anaesth, 2008, 100(4): 549-559.
12. 蓝岚. 单肺通气时间对肺损伤的影响. 南方医科大学, 2012.
13. 郑鑫林, 夏学阳, 张金周, 等. 胸腔镜下肺段切除与肺叶切除治疗临床Ⅰ期非小细胞肺癌疗效对比的 Meta 分析. 中国癌症杂志, 2016, 26(10): 854-860.
14. Saito H, Konno H, Atari M, et al. Management of intersegmental plane on pulmonary segmentectomy concerning postoperative complications. Ann Thorac Surg, 2017, 103(6): 1773-1780.
15. Okada M, Mimae T, Tsutani Y, et al. Segmentectomy versus lobectomy for clinical stage ⅠA lung adenocarcinoma. Ann Cardiothorac Surg, 2014, 3(2): 153-159.
16. 马少华, 闫天生, 王可毅, 等. 完全胸腔镜下解剖性肺段切除术治疗早期肺癌的体会. 中国肺癌杂志, 2018, 21(2): 99-103.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Wide exposure in uniportal video-assisted thoracoscopic surgery for radical resection of lung cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content