Single-port Versus Multi-port Thoracoscopic Lobectomy In Non Small Cell Lung Cancer: Propensity-score Matched Analysis
Kook Nam Han, Hyun Koo Kim, Young Ho Choi.
Korea University Guro Hospital, Seoul, Korea, Republic of.
OBJECTIVE: The aim of this study is to compare the oncologic outcome in patients with non-small cell lung cancer treated by single-port versus multi-port thoracoscopic lobectomy.
METHODS: 437 patients with non-small cell lung cancer who performed thoracoscopic lobectomy included between June 2005 and October 2015. Patients in both group (225 patients underwent multiport VATS and 215 patients underwent single port VATS) were matched by propensity-score method (1:1 matching, caliper 0.2, propensity score calculated using logistic regression). We compared the perioperative outcomes to evaluate the oncologic efficacy of single-port VATS lobectomy
RESULTS: After matching, 324 patients (162 in each group) were included our study. Both groups were comparable with preoperative variables (age, gender, FEV1, cell type and clinical stage). The mean operation time, the number of resected lymph node, and conversion to open thoracotomy did not show statistically significant differences (respectively, P=0.301, P=0.393, P=0.652). There was no difference in postoperative major morbidity (P=0.975). There was difference in timing to remove the chest drain (P<0.001). Survival (P=0.543) and recurrence free survival (P=0.804) in pathological stage IA and IB was not statistically different between groups.
CONCLUSIONS: Single-port thoracoscopic lobectomy showed acceptable mid-term oncologic outcomes compared with multi-port approach for thoracoscopic lobectomy.
|Operation time||195 ± 66 (65-537)||186 ± 61 (187-405)||0.301|
|No. of Lymph node||19 ±10 (4-56)||20 ± 11 (2-59)||0.393|
|Conversion to open||9 (5.6%)||11 (6.8%)||0.652|
|Morbidity||12 (7.4%)||10 (6.2%)||0.975|
|Mortality(<30days)||1 (0.6%)||4 (2.5%)||0.002|
|Chest drain removal(days)||5 ± 1 (3-12)||4 ± 2 (2-10)||<0.001|
|Follow-up duration (Months)||54 ± 30 (2-127)||26 ± 14 (0-52)||<0.001|
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