title: Uniportal video-assisted thoracic surgery: the lesser invasive thoracic surgery.
abstract: OBJECTIVE
  We evaluated whether single-port video-assisted thoracic surgery is feasible without compromising outcomes, and whether the technique could be reproduced by a trainee.
  
  
  METHODS
  In a 6-month period, 37 operations were performed by single-port video-assisted thoracic surgery. Of the 37 patients, 27 (73%) were male and the mean age was 45.1 ± 21 years. Twenty-three (62%) were operated on by consultants and 14 (38%) by trainees. The procedures included 19 (51.3%) operations for treatment of pneumothoraces, 8 (21.6%) metastasectomies, 7 (18.9%) lung biopsies, 2 (5.4%) empyema débridements, and 1 (2.7%) pleuropericardial window.
  
  
  RESULTS
  Mean operative time was 51.8 ± 14.7 min. Patient-controlled analgesia infusion was used for 1.3 ± 1 days. Three (8.1%) patients needed an operative reintervention, but there was no intensive treatment unit admission or hospital mortality. Mean postoperative hospital stay was 3.3 ± 2.7 days. On follow-up, all patients had a tissue diagnosis and all lung nodules were R0 resections. Patients operated on by consultants and trainees had similar preoperative profiles and postoperative outcomes, except that those operated on by trainees used patient-controlled analgesia significantly longer (1.8 ± 1.48 vs. 1 ± 0.48 days; p = 0.03).
  
  
  CONCLUSIONS
  Single-port video-assisted thoracic surgery can be performed and reproduced well without compromising outcomes. It is considered aesthetically better and may reduce analgesic requirements, but it might not reduce hospital stay.
authors.affiliation: Wessex Cardiothoracic Centre, University Hospital, Southampton, UK.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Roubelakis
authors.forename: Amit
authors.initials: A
authors.lastname: Modi
authors.forename: Melanie
authors.initials: M
authors.lastname: Holman
authors.forename: Gianluca
authors.initials: G
authors.lastname: Casali
authors.forename: Ali Zamir
authors.initials: AZ
authors.lastname: Khan
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000193:education / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Biopsy; Lung diseases; Pain; Pneumothorax; Thoracic surgery; postoperative; video-assisted