Single-port thoracoscopic anatomic segmentectomy for early-stage non-small cell lung cancer

Abstract

Objective To summarize the clinical experience of single-port thoracoscopic anatomic segmentectomy for early-stage non-small-cell lung cancer(NSCLC). Methods The clinical data of 27 patients undergoing single-port thoracoscopic anatomic segmentecomy for early-stage NSCLC in Department of Thoracic Surgery, Union Hospital affiliated to Fujian Medical University between May 2014 and March 2015 were retrospectively analyzed. A double lumen endotracheal tube was input, and the contralateral one-lung ventilated. A 4-5 cm incision was put on the anterior axillary line in the 4th or 5th intercostal space. Anatomic segementecomy was carried out firstly, and mediastinal lymph node dissection or sampling was executed when NSCLC was confirmed by intraoperative frozen pathology. The outcomes included perioperative parameters (operative time, volume of blood loss, duration of drainage, length of postoperative hospital stay, etc.), oncological results (total number of lymph node resection, total number of mediastinal lymph node resection, and number of stations of mediastinal lymph node resection), and pain score. Results All cases of single-port thoracoscopic surgery were completed, without adding auxiliary incision or converting to thoracotomy. There was no case of perioperative death, while there were 3 cases of complications (2 cases of pulmonary infection, and 1 case of arrhythmia), with the prevalence of complications of 11.1%. All cases of complications were cured. The mean operative time was (192.2 ± 56.1) min, the volume of blood loss was (83.8 ± 50.5) ml, the duration of drainage was (4.5±1.3) d, the length of postoperative hospital stay was (6.2±2.7) d, and the postoperative pain VAS score was (3.4 ± 0.9). The total number of lymph node dissection was (13.7±5.3), the total number of mediastinal lymph node dissection was (9.5 ± 4.3), and the number of stations of mediastinal lymph node dissection was (5.6±1.3). Conclusion In an center with extensive experience of thoracoscopic surgery, the single-port thoracoscopic anatomic segmentectomy for early-stage NSCLC is technically feasible and safe, and is a more minimally invasive surgical approach. Key words: Single-port; Thoracoscopic surgery; Segmentectomy; Non-small-cell lung cancer