title: Transumbilical Thoracoscopy Versus Conventional Thoracoscopy for Lung Wedge Resection: Safety and Efficacy in a Live Canine Model.
abstract: OBJECTIVE
  Transumbilical single-port surgery has been associated with less postoperative pain and offers better cosmetic outcomes than conventional 3-port laparoscopic surgery. This study compares the safety and efficacy of transumbilical thoracoscopy and conventional thoracoscopy for lung wedge resection.
  
  
  METHODS
  The animals (n = 16) were randomly assigned to the transumbilical thoracoscopic approach group (n = 8) or conventional thoracoscopic approach group (n = 8). Transumbilical lung resection was performed via an umbilical incision and a diaphragmatic incision. In the conventional thoracoscopic group, lung resection was completed through a thoracic incision. For both procedures, we compared the surgical outcomes, for example, operating time and operative complications; physiologic parameters, for example, respiratory rate and body temperature; inflammatory parameters, for example, white blood cell count; and pulmonary parameters, for example, arterial blood gas levels. The animals were euthanized 2 weeks after the surgery for gross and histologic evaluations.
  
  
  RESULTS
  The lung wedge resection was successfully performed in all animals. There was no significant difference in the mean operating times or complications between the transumbilical and the conventional thoracoscopic approach groups. With regard to the physiologic impact of the surgeries, the transumbilical approach was associated with significant elevations in body temperature on postoperative day 1, when compared with the standard thoracoscopic approach.
  
  
  CONCLUSIONS
  This study suggests that both approaches for performing lung wedge resection were comparable in efficacy and postoperative complications.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital at Keelung, Chang Gung University, Taiwan, ROC.
authors.forename: Tzu-Ping
authors.initials: TP
authors.lastname: Chen
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.lastname: Yen-Chu
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.forename: Chi-Ju
authors.initials: CJ
authors.lastname: Yeh
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.forename: Chien-Ying
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.forename: Ming-Ju
authors.initials: MJ
authors.lastname: Hsieh
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.forename: Hsu-Chia
authors.initials: HC
authors.lastname: Yuan
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC.
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Ko
authors.affiliation: Chang Gung Memorial Hospital at Linko, Chang Gung University, Taiwan, ROC zebraairmail@gmail.com.
authors.forename: Yun-Hen
authors.initials: YH
authors.lastname: Liu
mesh_terms: D000818:Animals; D004285:Dogs; D008168:Lung / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods; D061214:Patient Safety; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods; D014472:Umbilicus / Q000601:surgery*
keywords: NOTES; SILS; evidence-based medicine/surgery; single-site surgery