Single-port Video-assisted Thoracoscopic Surgery for Primary Lung Cancer: A Single Center Experience
Do Kyun Kang, InHa Kim, Woon Heo, Sung Kwang Lee, Ho-Ki Min, Hee Jae Jun, Youn-ho Hwang.
Haeundae Paik Hospital, Busan, Korea, Republic of.
OBJECTIVE: As the technique of video-assisted thoracoscopic surgery (VATS) evolved, single-port VATS lobectomy became possible and its advantages have been reported. We analyzed our experiences to evaluate the feasibility of single-port VATS lobectomy for primary lung cancer.
METHODS: Single-port VATS lobectomy for primary lung cancer was attempted in 40 patients in Haeundae Paik Hospital from June 2012 to November 2015. In 7 patients, the surgery was converted to open thoracotomy or three-port VATS lobectomy. Single-port VATS lobectomy was performed in 33 patients as planned. All patients underwent a lobectomy and systematic lymph node dissection using 5mm-30 degree thoracoscope through 4-5cm sized single incision. R0 resection was performed in all patients. We reviewed the medical records of these patients retrospectively.
RESULTS: There were 23 males and 10 females. Left upper lobectomy was the most frequent resection (11 patients). There was severe pleural adhesion in 10 patients. Twenty two patients (66.7%) had an incomplete fissure. The mean number of the dissected lymph node was 29.3±13.3 (range, 10-63). The mean number of the explored nodal stations was 6.4±1.3 (range, 4-9). The mean size of tumor was 2.7±1.2 cm (range, 1.3-6.0). The mean operation time was 224.7±81.5 minutes (range, 100-495) and it was getting decreased gradually as growing in experience. The operation time of the patients with complete fissure was shorter than that of the patients with incomplete fissure (p=0.003). However, pleural adhesion and tumor size did not associate with the operation time. The mean duration of the chest tube drainage was 6.5±3.9 days (range, 2-22). The mean duration of the hospital stay was 11.0±5.8 days (range, 6-34). There was no surgical mortality. There was a postoperative chylothorax in one patient.
CONCLUSIONS: In our experiences, single-port VATS lobectomy for primary lung cancer was safe and feasible. To evaluate the feasibility of single-port VATS for primary lung cancer, more experiences and long term follow-up would be required in well selected patients
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