Oncological clearance of uniportal vats for early stage non-small cell lung cancer

Abstract

: The uniportal video-assisted thoracic surgery (uVATS) approach may induce one of the least access traumas of all surgical approaches for anatomical lung resection and mediastinal lymph node staging for lung cancer. Numerous studies have shown uniportal VATS to be associated with reduce postoperative pain and analgesic requirement when compared with multiport VATS approaches. However, many in the thoracic surgical community remains skeptical of its oncological clearance, because a singular plane of visualisation and instrumentation is felt to be a hindrance to thorough mediastinal lymph node sampling or dissection. In this article, the evolutionary basis of VATS from multiportal to uniportal is explored. The existing evidence regarding oncological clearance by the uniportal approach is appraised, and the effect of surgeon experience in uniportal VATS on oncological clearance is examined. Early evidence thus far suggests that in experienced hands, the completeness of uniportal mediastinal lymph node staging is equivalent to multiportal approaches. More high-quality evidence in this arena is warranted.