Abstract
BackgroundThis study is to evaluate the feasibility and safety of video-assisted thoracoscopic (VATS) lobectomy with two incisions.MethodsA total of 73 patients (male 47, female 26; mean age 61.2 ± 12.00 years old) who underwent major pulmonary resection, through VATS, using two incisions were included in this study. The thoracoscopy port was placed at the 7th or the 8th intercostal space in the mid-axillary line, and the working port, 3~5 cm long, at the 5th intercostal space, on the operator’s side.ResultsThe preoperative diagnosis was benign lung disease in 8 patients (11.0%) and malignant lung disease in 65 (89.0%). Two patients (3.1%) needed a third port during surgery due to severe pleural adhesion, and conversion to thoracotomy was needed in 5 (6.8%), due to bleeding at pulmonary arterial branch (n = 3), anthracofibrotic lymph nodes around pulmonary artery (n = 1), and severe pleural adhesion (n = 1). The mean duration of the operation in the 66 patients, completed by a two-incision VATS lobectomy, was 163.4 ± 30.40 minutes. In 56 cases, which were completed by a two-incision VATS lobectomy for primary lung cancer, a total number of dissected lymph nodes per patient were 20.2 ± 11.2. The chest tube was removed on postoperative day 5.4 ± 2.8, and there was no occurrence of major perioperative morbidity and mortality.ConclusionsTwo-incision VATS lobectomy is applicable in the selected cases, and may obtain similar results with the conventional VATS lobectomy, through a certain period of learning curve.
Highlights
This study is to evaluate the feasibility and safety of video-assisted thoracoscopic (VATS) lobectomy with two incisions
Since the first video-assisted thoracic surgery (VATS) lobectomy, with anatomic hilar dissection performed in 1992, the frequency of this procedure has increased due to its attractiveness as a minimally invasive modality, which results in fewer postoperative complications, and reduces the duration of pleural drainage, as well as a reduction in the length of the hospital stay [1,2,3,4,5]
The third port was already made at the beginning of the operation, we occasionally did not use this port during a VATS lobectomy procedure
Summary
This study is to evaluate the feasibility and safety of video-assisted thoracoscopic (VATS) lobectomy with two incisions. Borro and colleagues [15] reported the feasibility of VATS lobectomy with two ports and said that the 3rd port is not necessary for the majority of cases, despite the use of three ports by most of the surgeons. The third port was already made at the beginning of the operation, we occasionally did not use this port during a VATS lobectomy procedure. This is because, on a usual case, the operator only used the working port, which was made at the operator’s side, and the assistant used the thoracoscopic port. In this study we evaluated the safety and feasibility of VATS lobectomy with two incisions
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