Dataset Information

Uniportal video-assisted thoracoscopic left pneumonectomy: Retrospective analysis of eighteen consecutive patients from a single center.

ABSTRACT:

Background

Uniportal video-assisted thoracoscopic surgery (VATS) is being more widely used in lung cancer, yet reports on its application in pneumonectomies are limited. This study aimed to evaluate the safety and feasibility of uniportal video-assisted thoracoscopic left pneumonectomy for lung cancer.

Methods

A series of 18 lung cancer patients who had received uniportal video-assisted thoracoscopic left pneumonectomies were included in the study. Their clinical, pathological, and surgical features, as well as postoperative recovery, were analyzed.

Results

The majority of the patients were male and smokers and their average age was 62.0 ±?8.9?years. All had primary lung cancer, while three (16.7%) had received neoadjuvant therapy. A total of 16 (88.9%) patients had stage II-III disease, with an average tumor size of 3.6 ±?1.5 cm. The average surgery time was 137.4 ±?47.0 minutes, with a 16.7% (3/18) conversion rate. The mean blood loss was 37.5 ±?59.4 mL and no patients needed blood transfusion during, or after, surgery. There was no perioperative death and the overall complication rate was 22.2% (4/18). Two (11.1%) patients needed to stay in the intensive care unit after surgery, and the average length of hospital stay after surgery was 6.3 ±?1.1?days (range 4-7?days).

Conclusions

Uniportal video-assisted thoracoscopic left pneumonectomy is a safe and feasible procedure for selected lung cancer patients. The use of uniportal VATS in right pneumonectomies and the effect of uniportal video-assisted thoracoscopic pneumonectomy on the survival of patients merits further study. Patients receiving uniportal VATS pneumonectomies had standard surgical results and recovery. Uniportal VATS pneumonectomy is safe for properly selected lung cancer patients.

Key points

Significant findings of the study: • Patients receiving uniportal VATS left pneumonectomies had standard surgical results and recovery.

What this study adds

• Uniportal VATS left pneumonectomy is safe for properly selected lung cancer patients.

SUBMITTER: Li J

PROVIDER: S-EPMC7862792 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Uniportal video-assisted thoracoscopic left pneumonectomy: Retrospective analysis of eighteen consecutive patients from a single center.

Li Jiagen J Xue Qi Q Gao Yushun Y Mao Yousheng Y Zhao Jun J Gao Shugeng S

Thoracic cancer 20210106 3

<h4>Background</h4>Uniportal video-assisted thoracoscopic surgery (VATS) is being more widely used in lung cancer, yet reports on its application in pneumonectomies are limited. This study aimed to evaluate the safety and feasibility of uniportal video-assisted thoracoscopic left pneumonectomy for lung cancer.<h4>Methods</h4>A series of 18 lung cancer patients who had received uniportal video-assisted thoracoscopic left pneumonectomies were included in the study. Their clinical, pathological, an ...[more]

PMID: 33410290

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Project description:BackgroundIn recent years, opportunities to conduct anatomical segmentectomies for early stage lung cancer, metastatic lung tumor, and so on have been increasing. Generally, uniportal video-assisted thoracoscopic surgery (U-VATS) uncommon segmentectomy is technically more complicated because of limited angulation compared to multiportal VATS (M-VATS) and the need to treat peripheral vessels/bronchi compared to common segmentectomy. This study aimed to determine the safety and feasibility of U-VATS uncommon segmentectomy compared with U-VATS common segmentectomy and M-VATS uncommon segmentectomy.MethodsWe retrospectively reviewed the medical records of 76 patients in the M-VATS group and 45 patients in the U-VATS group who underwent VATS segmentectomy from January 2015 to December 2020. During that period, the perioperative results of U-VATS uncommon (n=22) segmentectomy were compared with those of U-VATS common (n=23) and M-VATS uncommon (n=37) segmentectomy. Uncommon segmentectomy was defined as any segmentectomy other than segmentectomies of the lingual, basilar, or superior segment of the lower lobe (S6), and upper division of the left upper lobe. All patients in our department underwent preoperative three-dimensional computed tomography (3D-CT) angiography and bronchography to image bronchovascular structures and determine the resection line.ResultsPatients characteristics were similar between the U-VATS uncommon segmentectomy group and the U-VATS common segmentectomy group or the M-VATS uncommon segmentectomy group. In U-VATS, there were no significant differences between common and uncommon segmentectomy in operation time, postoperative drainage, postoperative hospitalization, and postoperative complications. Comparing M-VATS and U-VATS uncommon segmentectomies, operation time (145±35 vs. 185±44 min, P<0.001) and postoperative hospitalization (3.1±1.6 vs. 4.2±1.8 days, P=0.02) were significantly shorter in the U-VATS group than in the M-VATS group. There were no significant differences in blood loss, intraoperative bleeding, duration of postoperative drainage and postoperative complications.ConclusionsIn U-VATS, both types of segmentectomies can be achieved with similar results. Moreover, U-VATS shortened operation time and postoperative hospitalization in uncommon segmentectomy compared with conventional M-VATS. U-VATS is a useful approach for uncommon segmentectomy.

Project description:Background:Cough is one of the shared complications after lung surgery. In this study, a prospective analysis was conducted for exploring the risk factors of persistent cough after uniportal video-assisted thoracoscopic pulmonary resection. Methods:One hundred thirty-five patients with pulmonary nodules who underwent surgical treatment in the same surgical group from November 2019 to January 2020 were enrolled in this prospective study. The severity of cough and its impact on patients' quality of life before and after surgery were assessed by the Mandarin Chinese version of the Leicester cough questionnaire (LCQ-MC), and postoperative cough was tested by the cough visual analog scale (VAS) and cough symptom score (CSS). Risk factors of cough after pulmonary resection (CAP) were determined by univariate and multivariate logistic regression analysis. Results:The incidence of postoperative cough was 24.4% (33 of 135 patients). Univariate analysis showed that gender (female), the surgical site (upper right), the resection (lobectomy), subcarinal lymph node dissection, postoperative acid reflux, length of hospitalization contributed to the development of CAP resection. Multivariate logistic regression analysis showed that the resection (lobectomy) (OR 3.590, 95% CI: 0.637-20.300, P=0.017), subcarinal lymph node dissection (OR 4.420, 95% CI: 1.342-14.554, P=0.001), postoperative acid reflux (OR 13.55, 95% CI: 3.186-57.633, P<0.001) and duration of anesthesia (over 153 minutes, OR 0.987, 95% CI: 0.978-0.997, P=0.011) were independent risk factors for postoperative cough. Conclusions:The application of uniportal video-assisted thoracoscopic techniques to several types of lung surgery are conducive to enhanced recovery after surgery (ERAS). Postoperative cough is related to an ocean of factors, the resection (lobectomy), subcarinal lymph node dissection, postoperative acid reflux, and duration of anesthesia (over 153 minutes) are independent high-risk factors for CAP resection. Trial registration:This study was registered on ClinicalTrials.gov (NCT04204148).

Dataset Information

Uniportal video-assisted thoracoscopic left pneumonectomy: Retrospective analysis of eighteen consecutive patients from a single center.

Background

Methods

Results

Conclusions

Key points

What this study adds

Publications

Uniportal video-assisted thoracoscopic left pneumonectomy: Retrospective analysis of eighteen consecutive patients from a single center.

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