137. THE COMPARISON OF UNIPORTAL VERSUS MULTIPORTAL VIDEO-ASSISTED THORACIC SURGERY FOR ESOPHAGEAL CANCER: A PROPENSITY-WEIGHTED ANALYSIS

Abstract

Abstract Background Uniportal video-assisted thoracoscopic surgery (VATS) has been widely used, however, there are few studies on uniportal VATS for esophagectomy. Methods Data from patients with clinical stage T1–3/N0/M0 thoracic esophageal cancer who underwent surgery between January 2017 and December 2020 were prospectively enrolled and retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to assess the outcomes. Results Overall, 55 patients who underwent uniportal, and 212 patients who underwent multiportal, VATS were identified. Surgery-related postoperative complications (Clavien-Dindo grades 1–2) occurred less frequently after uniportal than multiportal VATS in both crude and IPTW models (8.1% versus 29.3%, respectively; P = 0.009). The median postoperative length of stay was 9 (9–10) days in the uniportal VATS and 10 (9–14) days in the multiportal VATS group (P = 0.025 after IPTW). Upon IPTW analysis, in uniportal and multiportal VATS groups, the rates of pneumonia were 10.6% and 26.9% (P = 0.040), while the rates of anastomotic fistulae (grade 2) were 1.0% and 6.6% (P = 0.036), respectively. The visual analog scale (VAS) was administered on postoperative first 7 days and were significantly lower in the uniportal VATS group (P < 0.001). No surgical mortality was observed in the uniportal VATS group, and the survival benefit between the two groups was comparable before (P = 0.732) and after IPTW (P = 0.542). Conclusions Uniportal VATS for esophagectomy resulted in a lower rate of postoperative complications with less postoperative pain, and is practical for treating patients with esophageal cancer.