title: One-port videothoracoscopic surgical intervention.
abstract: BACKGROUND
  One-port video-assisted thoracic surgery (VATS) has recently been proposed as an alternative to conventional 3-port VATS. To reduce pain, chest wall paresthesia, and hospital stay, lesser ports are the current direction.
  
  
  METHODS
  From 2007 to 2010, 98 patients underwent 1-port VATS procedure. The charts were retrospectively evaluated. A 2.5 cm long incision was made at the sixth intercostal space in the median axillary line. A single flexible port was used. Both the camera and the endoinstruments were introduced through the port. Patient characteristics, visual analog score, and postoperative paresthesia scores were evaluated.
  
  
  RESULTS
  The study enrolled 38 women and 60 men with the mean age of 49.1±1.5 years (range, 19 to 75 y). Thirty-one patients (28.6%) were diagnosed with malignant pleural effusion. Perioperative pleurodesis with talc was performed in 81% of them. One-port VATS approach was used for pleura biopsies in 77 (78.6%), wedge resection in 4 (3.8%), pleurectomy in 13 (12.4%), and biopsy with talc chemical pleurodesis in 4 (3.8%) instances. The mean operation time was 24.4 minutes (range, 15 to 50 min). No major cardiorespiratory or surgical complications were noted. The median observation time was 60 months (range, 36±81 mo). Among benign pathology patients, 56 (82.3%) of them did not complain about any pain; however, 12 patients had prolonged discomfort (2 pinprick, 6 numbness, and 4 pruritus).
  
  
  CONCLUSIONS
  One-port VATS in selected patients are feasible and seems to be safe in thoracic surgical interventions instead of conventional 3 ports that was presented in this series.
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Educational and Research Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Kiral
authors.forename: Cagatay
authors.initials: C
authors.lastname: Tezel
authors.forename: İlhan
authors.initials: İ
authors.lastname: Ocakcioglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Vayvada
authors.forename: Serkan
authors.initials: S
authors.lastname: Bayram
authors.forename: Senol
authors.initials: S
authors.lastname: Urek
authors.forename: Levent
authors.initials: L
authors.lastname: Alpay
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D010292:Paresthesia / Q000209:etiology / Q000517:prevention & control*; D010995:Pleural Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
references.citation: Cooper JD. Perspectives on thoracoscopy in general thoracic surgery. Ann Thorac Surg. 1993;56:697–700.
references.citation: Rusch VW, Bains MS, Burt ME, et al.. Contribution of video thoracoscopy to the management of the cancer patient. Ann Surg Oncol. 1994;1:94–98.
references.citation: Rocco G, Romano V, Accardo R, et al.. Awake single-access (uniportal) video-assisted thoracoscopic surgery for peripheral pulmonary nodule in a complete ambulatory setting. Ann Thorac Surg. 2010;89:1625–1627.
references.citation: Rocco G, Ucar AM, Passera. E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg. 2004;77:726–728.
references.citation: Martinez-Ferro M, Duarte S, Laje P. Single port thoracoscopy for the treatment of pleural empyema in children. J Pediatr Surg. 2004;39:1194–1196.
references.citation: Assouad J, Vignes S, Nakad J, et al.. Single incision video-assisted thoracic surgery using a laparoscopic port. Ann Thorac Surg. 2011;91:2020–2021.
references.citation: Fredman B, Zohar E, Shachor D, et al.. Video-assisted transthoracic sympathectomy in the treatment of primary hyperhidrosis: friend or foe. Surg Laparosc Endosc Percutan Tech. 2000;10:226–229.
references.citation: Maguire MF, Ravenscroft A, Beggs D, et al.. A questionnaire study investigating the prevalence of the neuropathic component of chronic pain after thoracic surgery. Eur J Cardiothorac Surg. 2006;29:800–805.
references.citation: Furrer M, Rechsteiner R, Eigenmann V, et al.. Thoracotomy and thoracoscopy: post-operative pulmonary function, pain and chest wall complaints. Eur J Cardiothorac Surg. 1997;12:82–87.
references.citation: Stammberger U, Steinacher C, Hillinger S, et al.. Early and long-term complaints following video-assisted thoracoscopic surgery: evaluation in 173 patients. Eur J Cardiothorac Surg. 2000;18:7–11.
references.citation: Rajesh YS, Pratap CP, Woodyer AB. Thoracoscopic sympathectomy for palmar hyperhidrosis and Raynaud's phenomenon of the upper limb and excessive facial blushing: a five year experience. Postgrad Med J. 2002;78:682–684.
references.citation: Gossot D, Kabiri H, Caliandro R, et al.. Early complications of thoracic endoscopic sympathectomy: a prospective study of 940 procedures. Ann Thorac Surg. 2001;71:1116–1119.
references.citation: Jutley RS, Khalil MW, Rocco G, et al.. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg. 2005;28:43–46.