Single-Port Video-Assisted Thoracoscopic Lobectomy for Non-small-Cell Lung Cancer—Learning Curve Analysis

Abstract

Uniportal video-assisted thoracoscopic surgery (UVATS) lobectomy has been gradually applied for the surgical treatment of resectable non-small-cell lung cancer (NSCLC). The purposes of this study were to analyze the learning curve of uniportal video-assisted thoracoscopic surgery lobectomy for the treatment of resectable non-small-cell lung cancer and discuss the clinical application value. We retrospectively evaluated 160 consecutive patients with non-small-cell lung cancer who underwent intended uniportal video-assisted thoracoscopic surgery lobectomy by a single surgical team in our ward between May 2016 and April 2017. The patients were divided into four groups in chronological order. The general clinical date, perioperative data, and postoperative complications were individually compared and analyzed among the four groups. The four groups were similar in terms of incision length, chest tube duration, total number of dissected lymph nodes, and nodal stations and postoperative length of stay. The differences of operative time (185.9 SD 17.9 versus 139.9 SD 10.7 versus 128.7 SD 7.8 versus 124.0 SD 9.3 min), intraoperative blood loss (233.9SD135.8 versus 126.8SD18.1 versus 116.4 SD 22.6 versus 112.8 SD 25.3 ml), conversion rate (17.5% versus 7.5% versus 5.0% versus 5.0%), and postoperative complications rate (27.5% versus 10.0% versus 10.0% versus 7.5%) were significant among the four groups (p < 0.05). Compared with group A, the operative time and intraoperative blood loss were significantly decreased in groups B, C, and D, with significant differences (p < 0.05). Uniportal video-assisted thoracoscopic surgery lobectomy can be safely and feasibly performed on resectable non-small-cell lung cancer; the learning curve of uniportal video-assisted thoracoscopic surgery lobectomy is approximately 40 cases. The operative time, intraoperative blood loss, postoperative complications, and conversion rates can be used as the main measure indexes for surgery.