Early Postoperative Results of Patients Undergoing Uniportal Video-Assisted Thoracoscopic Lobectomy and Their Assessment with The Systemic Inflammation Scoring System

Abstract

Background & Aim: Uniportal video-assisted thoracoscopic surgery (u-VATS) is a minimally invasive approach that allows thoracic operations to be performed through a single small incision of approximately 4 cm. The Systemic Inflammation Score (SIS) is a scoring system that can be measured easily and inexpensively in routine clinical practice and consists of three laboratory parameters, which are serum albumin level, lymphocyte count, and monocyte count. Scoring systems can provide low-cost and easily attainable objective information that can assist surgeons in evaluating patients. The aim of this study was to examine the early postoperative results of patients who underwent u-VATS lobectomy and to evaluate the relationship of these results with the systemic inflammation scoring system. Methods: Age, gender, smoking habits, preoperative lymphocyte and monocyte counts, preoperative albumin values, comorbidities, operative times, length of hospital stay, chest tube removal time, duration of air leak, amount of drainage, and postoperative complications of patients who underwent u-VATS lobectomy operation in our clinic between March 2018 and March 2020 were retrospectively analyzed. Patients were classified by the SIS based on preoperative serum albumin (ALB) level and lymphocyte-to-monocyte ratio (LMR) as follows: SIS=0, ALB ?4.0 g/dL and LMR ?3.4; SIS=1, ALB <4.0 g/dL or LMR <3.4; and SIS=2, ALB <4.0 g/dL and LMR <3.4. Results: The number of patients who underwent u-VATS lobectomy was 42. There were 12 patients in the SIS 0 group, 19 patients in the SIS 1 group, and 11 patients in the SIS 2 group. The amount of postoperative drainage (p=0.000), chest tube removal time (p=0.006), and length of hospital stay (p=0.000) were correlated with systemic inflammatory scores of patients. The rate of developing postoperative complications was found to increase to almost a statistically significant level as the systemic inflammatory scores of patients increased (p=0.084). There was no significant difference between the SIS groups in terms of other parameters. Conclusion: Patients who underwent u-VATS lobectomy and had a high preoperative systemic inflammation score had higher amounts of postoperative drainage, longer duration of chest tube and length of hospital stay. The SIS scoring system is a simple, effective risk stratification method that can be routinely used for patients undergoing u-VATS lobectomy. Keywords: Uniportal Video-Assisted Thoracoscopy, Lobectomy, Systemic Inflammation Scoring System, Thoracic Surgery