Objective To explore the learning curve and evaluate the safety of uniportal complete video-assisted thoracoscopic surgery (VATS) lobectomy. Methods We reviewed retrospectively the clinical data of 133 patients, who underwent uniportal VATS between March 2015 and October 2016 in Sichuan Provincial Cancer Hospital. There were 79 males and 54 females at age of 52.21±10.77 years. Results All the 127 patients completed uniportal VATS, 4.51% (6/133) converted to open surgery. There were 78 patients with lobectomy, 6 patients with segmentectomy, 37 patients with wedge resection, 6 patients with pleural, mediastinal lymph node biopsy or mediastinal tumor resection. In the lobectomy group, mean surgical time was 148.75±34.12 min, mean blood loss was 118.87±59.96 ml, mean number of lymph nodes was 11.25±6.15, the mean duration of chest-tube placement was 2.17±1.35 days, and mean length of stay was 7.58±2.59 days. Conclusion Based on skillful performance of the conventional thoracoscopic lobectomy, the learning curve for single port thoracoscopic lobectomy comprises at least 20 patients. The uniportal VATS lobectomy is a safe and operable method of minimally invasive technique, and it is worthy to be applied in thoracic surgery.
Objective To compare the effect of uniportal and multiportal thoracoscopic lobectomy, and to explore the advantages and applications of uniportal thoracoscopic lobectomy in enhanced recovery after surgery. Methods Totally 169 patients with video-assisted thoracoscopic lobectomy in Department of Thoracic Surgery of Sichuan Cancer Hospital from January to December 2016 were enrolled. There were 99 males and 70 females with age of 60.83±7.24 years. Patients were divided into two groups: a uniportal group (78 patients) and a multiportal group (91 patients) . Patients’ clinical and pathological materials were collected. Postoperative pain, complications and hospital stay, etc of the two groups were compared. Results All patients were successfully discharged without serious postoperative complication or death. Patients in the multiportal group had smaller surgical incisions than that in the uniportal group (3.12±0.73 cm vs. 6.38±1.50 cm, P=0.016). Pain scores at postoperative 24 and 48 hours of the uniportal group were less than those of multiportal group (4.18±1.67 vs. 6.54±1.83, 3.05±1.47 vs. 4.68±1.64, P<0.05). Operation data, postoperative complications and hospital stay were similar in both groups. Conclusion Uniportal video-assisted thoracoscopic lobectomy makes smaller incisions and can further reduce postoperative pain and dosage of morphine. The operation is safe and worthy of wide application in enhanced recoveryafter surgery.
ObjectiveTo investigate the preoperative symptom burden and quality of life of patients undergoing lung cancer surgery.MethodsThis study was a cross-sectional study. We used the MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) and the single-item quality of life scale (UNISCALE) to collect the preoperative patient-reported outcomes of 265 patients with lung cancer from November 2017 to July 2019 in Sichuan Cancer Hospital.ResultsOf 265 patients, 90.9% had preoperative symptoms. The five most common symptoms were coughing (66.8%), dry mouth (53.6%), memory problems (52.8%), disturbed sleep (52.1%) and fatigue (44.2%). The five most common moderate to severe symptoms were disturbed sleep (23.0%), distress (18.5%), memory problems (16.6%), coughing (16.2%) and dry mouth (16.2%). Patients with early-stage lung cancer had less pain, fatigue, shortness of breath, lack of appetite, numbness and coughing, and their symptoms had less impact on work (including housework), relations with other people, walking and enjoyment of life as well as better quality of life before surgery (P<0.05). Patients with adenocarcinoma had milder coughing and a better quality of life before surgery (P<0.05). Symptom score was positively correlated with symptom interference with life score (r=0.66, P<0.01) and negatively correlated with quality of life score (r=-0.41, P<0.01).ConclusionMost patients undergoing lung cancer surgery have a mild symptom burden before surgery. The most common and severe symptoms are coughing, dry mouth, lung cancer and disturbed sleep. Patients with early-stage lung cancer have a milder symptom burden and a better quality of life.