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International Society For Minimally Invasive Cardiothoracic Surgery

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Uniportal Vats Major Pulmonary Resections: From 2% To 74% Of Major Lung Resections During The 4-year Period
Aleksandra Chrzastek, Przemysław Bławat, Maciej Dancewicz, Łukasz Żołna, Mariusz Bella, Aleksandra Burysz, Błażej Przybysławski, Janusz Kowalewski.
Oncology Centre, Bydgoszcz, Poland, Bydgoszcz, Poland.

BACKGROUND: Uniportal video-assisted thoracic surgery (VATS) has revolutionized the way thoracic surgeons treat pulmonary lesions. The aim of the present study was to investigate the implementation of this technique at our Clinic. METHODS: We evaluated each major pulmonary resection performed between January 1, 2016 and December 31, 2019. The analyzed parameters included type of the procedure, its length, patientís blood loss and the number of lymph nodes dissected.
RESULTS: In 2016 we performed 2% (3) of all major anatomical resections (132) by uniportal VATS with no conversions. In 2017- 33% (43 out of 129) with conversion rate 18,6%. In 2018- 50% (65 out of 130) with conversion rate 21,5%. Within four years of experience and obstinacy we reached 74% (112 out of 151) of major resections done by uniportal VATS with conversion rate 10,7%. For us the most important factor was one consultant surgeon trained abroad and then firstly performing uniportal VATS resections with young surgeons assisting. After couple of months residents started uniportal VATS resections with supervision of more experienced consultant surgeon. We started almost every surgery by uniportal VATS, and decided after quick evaluation if we were able to do the procedure. It is important to learn how to deal with complications in uniportal VATS.
CONCLUSIONS: Uniportal VATS is a feasible and safe technique with great benefits. Herein, we suggest in details how to apply it into the surgical practice.

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