Abstract
ObjectiveThis study aims to determine the optimal dividing order of anatomic pulmonary resection under uniportal video-assisted thoracoscopic surgery (uni-VATS) for patients with right upper peripheral lung cancer.MethodsPatients who met the eligibility criteria were randomly allocated into the aBVA and VAB groups. In the aBVA group, the surgical procedure proceeded from the posterior to the anterior region (from the deeper to the superficial site). In the VAB group, the dissection orders were vein first followed by arterial branches, followed by the bronchus. Clinical data were collected and analyzed.ResultsSixty patients were randomly allocated to the aBVA group (n = 30) and the VAB group (n = 30). The operation time in the aBVA group (230.500 ± 68.360 min) was significantly shorter than that in the VAB group (305.600 ± 107.821 min) (p = 0.01). The blood loss in the aBVA group (104.000 ± 70.935 ml) was significantly lower than that in the VAB group (391.000 ± 625.175 ml) (p = 0.01). Two patients in the VAB group underwent conversion to 2-portal VATS. The number of lymph nodes (13.367 ± 5.436 vs. 10.333 ± 7.279, p = 0.072) and lymph node stations (5.067 ± 1.574 vs. 4.467 ± 2.345, p = 0.567) were comparable between the two groups. The differences in the postoperative drainage tube time (5.033 ± 3.113 vs. 6.467 ± 4.447 days, p = 0.278) and hospital stay (8.233 ± 3.390 vs. 9.433 ± 4.523 days, p = 0.361) were not significantly different between the two groups.ConclusionCompared with the VBA procedure, aBVA is easier for patients with right upper peripheral lung cancer who undergo uni-VATS lobectomy.
Highlights
Lung cancer has the second highest incidence and highest mortality rate of cancer in both men and women worldwide [1]
This study aims to determine the optimal dividing order of anatomic pulmonary resection under uniportal video-assisted thoracoscopic surgery for patients with right upper peripheral lung cancer
Compared with the VBA procedure, aBVA is easier for patients with right upper peripheral lung cancer who undergo uni-video-assisted thoracoscopic surgery (VATS) lobectomy
Summary
Lung cancer has the second highest incidence and highest mortality rate of cancer in both men and women worldwide [1]. It is well known that surgical resection plays an important role in the comprehensive treatment of nonsmall cell lung cancer (NSCLC). In patients with NSCLC who underwent surgery, the right upper lobe had the highest incidence rate (23.8% to 47.0%) among the aBVA Procedure Is Easier five lung lobes [2,3,4,5,6,7]. The current National Comprehensive Cancer Network (NCCN) guidelines for NSCLC suggest that for medically operable disease, resection is the preferred local treatment modality (other modalities include stereotactic ablative radiotherapy, thermal ablation such as radiofrequency ablation, and cryotherapy), and that anatomic pulmonary resection is preferred for the majority of patients with NSCLC [8]. In this study, we attempted to distinguish the optimal order of anatomical pulmonary resection under uni-VATS for patients with right upper peripheral lung cancer
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