Multi-center retrospective study of single-port and multi-port video-assisted thoracoscopic anatomic lobectomy and segmentectomy

Abstract

Objective To assess the feasibility and perioperative outcomes of single-port and multi-port video-assisted thoracoscopic anatomic lobectomy and segmentectomy. Methods The clinical data of 458 patients undergoing video-assisted thoracoscopic anatomic lobectomy or segmentectomy in Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, Affiliated Hospital of National Taiwan University, University of HongKong Queen Mary Hospital, Shenzhen Hospital and Korea University Guro Hospital between 2013 and 2014 were retrospectively analyzed. Patients were divided into single-port thoracoscopic group and multi-port(including 2-port, 3-port and 4-port) thoracoscopic group according to surgical approaches. The parameters of duration of operation, volume of blood loss during operation, conversion of surgical approach, number and stations of lymph nodes harvested, postoperative chest tube drainage time, volume of chest tube drainage, postoperative hospitalization time, incidence of hospital readmission, perioperative morbidity and mortality, and pain score within 3 days after operation were compared between two groups. Results There was no significant difference in the number and stations of lymph nodes harvested, incidence of hospital readmission, postoperative morbidity and mortality, and pain score on the third day after operation between two group(P>0.05). The duration of operation and volume of blood loss during operation in single-port group were significantly longer or larger than those in multi-port group(t=2.039, P=0.042; χ2=23.534, P<0.001) The pain scores on the first day and second day after operation in single-port group were significantly lower than those in multi-port group(χ2=9.959, P=0.002; χ2=11.971, P<0.0001)5). Conclusions Single-port video-assisted thoracoscopic anatomic lobectomy and segmentectomy is a safe and feasible approach, which has less surgical trauma and postoperative pain than the traditional multiple-port approach. Key words: Thoracoscopy, Single-port, Multi-port; Perioperation; Pain