Abstract
BackgroundVideo-assisted thoracoscopic surgery (VATS) lobectomy is currently the recommended approach for treating early-stage non-small cell lung cancer (NSCLC). Different VATS approaches have been proposed so far, and the actual advantages of one technique over the other are still under debate. The aim of our study is to compare postoperative pain and analgesic drug consumption in uniportal VATS and triportal VATS for pulmonary lobectomy in early-stage lung cancer patients.MethodsThis study is a single-center, prospective, two-arm, parallel-group, randomized controlled trial. It is designed to compare uniportal video-assisted thoracic surgery (u-VATS) and three-port video-assisted thoracic surgery (t-VATS) in terms of postoperative pain. The trial will enroll 120 patients with a 1:1 randomization. The primary outcome is the assessment of analgesic drug consumption. Secondary outcomes are postoperative pain measurement, evaluation of postoperative pulmonary function, and metabolic recovery after pulmonary lobectomy.DiscussionThe choice of which VATS approach to adopt for treating patients undergoing pulmonary resection mostly depends on the surgeon’s preferences; therefore, it is hard to prove whether one VATS technique is superior to the other. Moreover, postoperative analgesic protocols vary consistently among different centers. To date, only a few studies have evaluated the effects of the most popular VATS techniques. There is no evidence about the difference between multiport VATS and u-VATS in terms of postoperative pain. We hope that the results of our trial will provide valuable information on the outcomes of these different surgical approaches.Trial registrationClinicalTrials.gov NCT03240250. Registered on 07 August 2017; retrospectively registered.
Highlights
Video-assisted thoracoscopic surgery (VATS) lobectomy is currently the recommended approach for treating early-stage non-small cell lung cancer (NSCLC)
It is a current opinion that VATS lobectomy is associated with a decreased risk of adverse events, less pain, and shorter length of stay when compared to open surgery [2]; these assumptions are validated by systematic reviews and meta-analyses, even though most of those trials were not randomized [3, 4]
The same group of authors conducted a systematic review and meta-analysis: pooled analyses showed significantly reduced pain according to visual analog scale (VAS) scores in uniportal VATS (u-VATS) patients compared to multiport VATS (m-VATS) patients on postoperative days 1, 3, 7, and 30
Summary
Video-assisted thoracoscopic surgery (VATS) lobectomy is currently the recommended approach for treating early-stage non-small cell lung cancer (NSCLC). The aim of our study is to compare postoperative pain and analgesic drug consumption in uniportal VATS and triportal VATS for pulmonary lobectomy in early-stage lung cancer patients. It is a current opinion that VATS lobectomy is associated with a decreased risk of adverse events, less pain, and shorter length of stay when compared to open surgery [2]; these assumptions are validated by systematic reviews and meta-analyses, even though most of those trials were not randomized [3, 4]. In 2011, Gonzales Rivas published the first results on pulmonary lobectomy performed via uniportal VATS (u-VATS) [12] This technique has progressively gained consensus, initially in Asian countries, thereafter in Europe [13]. The aim of our study is to compare the effects of u-VATS and tVATS for pulmonary lobectomy in early-stage lung cancer patients, in terms of postoperative pain
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