Abstract
Recently, video-assisted thoracic surgery (VATS) has been accepted as a feasible, safe and effective approach for the treatment of early lung cancer. With the evolution of the VATS technique, uniportal VATS for early lung cancer has been performed and its advantages has been reported including less postoperative pain, less paresthesia and favorable cosmetic results because only one intercostal space is involved. We analyzed our experiences to evaluate results of uniportal VATS in patients with early lung cancer. We analyzed retrospectively medical records of patients who underwent surgical treatments for stage I and II lung cancer at our institute between March 2011 and December 2018. There were 126 patients in multiportal group (MG) and 102 patients in uniportal group (UG). All patients underwent the lobectomy and mediastinal lymph nodes dissection. Multiport VATS was performed through 3 small incisions (2cm, 2cm and 4-5cm). Uniportal VATS was performed through only one 4-5cm sized incision (Figure 1). There was no difference between both groups in gender, age, underlying diseases, location of tumor, TNM stage, cell type and the number of dissected lymph nodes. The mean tumor size of UG was slightly smller than that of MG (2.5 vs 3.0 cm, p=0.02). The mean operation time of UG was shorter than that of MG (189 vs 214 minutes, p=0.01). The mean duration of tube drainage and hospital stay of UG was shorter than those of MG (tube drainage: 5.3 vs 6.7 days, p=0.01, hospital stay: 8.1 vs 11.1 days, p<0.01). There were 7 hospital mortalities in MG and 1 hospital mortality in UG (p=0.06). The cause of hospital mortality was ARDS in all patients. There were 4 complications (empyema, pneumothorax, chylothorax and persistent air leak) in MG and 4 complications (chylothorax, pneumothorax in 2 and pleural effusion) in UG. The 5-year disease free survival rate was 77% in MG and 90 % in UG (p=0.59). The 5-year survival rate was 81% in MG and 99% in UG. However, there was no statistically significant difference. In our study, uniportal VATS showed similar results with a smaller incision when compared to multiport VATS in the surgical treatment for stage I and II lung cancer. Uniportal VATS might be one of options in the surgery for stage I and II lung cancer.
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