Is single-port video-assisted thoracic surgery for mediastinal cystectomy feasible?

Nanqing Jiang,Jun Wang,Yiming Lu

doi:10.1186/s13019-019-0843-9

Nanqing Jiang, Jun Wang + Show 1 more

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https://doi.org/10.1186/s13019-019-0843-9

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Abstract

BackgroundVideo-assisted thoracic surgery (VATS) for mediastinal cysts has been used with increasing frequency. Both single-port VATS and three-port VATS procedures are used for mediastinal cystectomy. Few studies have been published to compare three-port VATS and single-port VATS procedures in mediastinal cystectomy.MethodsForty-five patients with mediastinal cysts who underwent single-port procedures (n = 23) or three-port procedures (n = 22) in our department from January 2016 to July 2018 were retrospectively analysed. The perioperative conditions and pathological findings were analysed.ResultsThe single-port group showed shorter operation times [45 (35–60) vs 55 (45–80) min, p = 0.013], less retention time of the thoracic drainage tube [27(24–48) vs 48(48–70) p < 0.001)], shorter postoperative hospital stays [5(4–6) vs 7(5–7), p = 0.011] and less costs [2.0)1.2–2.5) vs 2.5(1.9–3.5), p = 0.032] than those of the three-port group. No difference was found in case conversions to open procedures (p > 0.99) or second operations (p > 0.99). Logistic regression analysis showed that the surgical method (p = 0.426) and surgeon experience (p = 0.719) were not independent prognostic factors for the success of surgery.ConclusionsThe single-port VATS procedure was not inferior to the three-port VATS procedure for mediastinal cystectomy. The single-port VATS procedure is a feasible choice for mediastinal cystectomy.

Highlights

Cystic lesions account for 20–32% of all mediastinal lesions [1]
Categorical variables were compared using the Patient characteristics and laboratory findings Forty-five mediastinal cyst patients who underwent the single-port Video-assisted thoracic surgery (VATS) procedure (n = 22) and three-port VATS procedure (n = 23) in our department were included in this retrospective study
No statistically significant differences were found between the groups in terms of gender, age, body mass index (BMI), preoperative symptoms, forced expiratory volume in one second (FEV1.0), forced expiratory volume in one second/forced vital capacity (FEV1.0/ FVC), PaO2, serum creatinine, blood glucose or cyst location before surgery

Summary

Introduction

Cystic lesions account for 20–32% of all mediastinal lesions [1]. Most surgeons recommend surgical resection for mediastinal cysts [2]. Complete surgical excision is thought to be the standard therapy for mediastinal cysts [2]. The accuracy rate of the CT examination for mediastinal cysts is not 100% [3]. Some patients with mediastinal cysts have symptoms. The purpose of surgery is to make a definitive diagnosis and to improve symptoms in symptomatic patients. Video-assisted thoracic surgery (VATS) for mediastinal cysts has been used with increasing frequency. Both single-port VATS and three-port VATS procedures are used for mediastinal cystectomy. Few studies have been published to compare three-port VATS and single-port VATS procedures in mediastinal cystectomy

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