title: From biportal to uniportal video-assisted thoracoscopic anatomical lung resection: A single-institute experience.
abstract: Our study sought to review our experience from biportal to uniportal video-assisted thoracoscopic surgery (VATS) major lung resection. Lessons we learned from the evolution regarding technical aspects were also discussed.We retrospectively reviewed patients who underwent VATS lobectomy or segmentectomies in Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, during January 2012 and December 2014. Patient clinical profiles, surgical indications and procedures, postoperative course, and oncological parameters were analyzed and compared between the biportal and uniportal groups.A total of 121 patients were enrolled in this study with median follow-up of 19.5 ± 11.6 months for all patients and 22.5 ± 11.5 months for primary lung cancer patients. Operation time (146.1 ± 31.9-158.7 ± 40.5 minutes; P = 0.077), chest drainage time (3.8 ± 3.3-4.4 ± 2.4 days; P = 0.309), conversion to thoracotomy rate (2.2%-2.6%; P = 0.889), and complication rate (15.6%-19.7%; P = 0.564) were equal between the groups, whereas blood loss (96.7 ± 193.2-263.6 ± 367; P = 0.006) was lower in the uniportal group. For lung cancer cases, there were no statistical differences in the histology, cancer staging, mediastinal lymph node dissection stations, numbers of dissected N1, N2, and overall lymph nodes between uniportal and biportal groups.Our preliminary data showed that uniportal VATS anatomical lung resection is as feasible, equally safe, and of comparative oncological clearance efficacy to biportal VATS.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Chia-Yi Christian Hospital, Chia-Yi, Taiwan Graduate Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan Graduate Institute of Medical Sciences, College of Health Science, Chang Jung Christian University, Tainan, Taiwan Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, and Department of Respiratory Therapy, China Medical University Division of Thoracic Surgery, Department of Surgery, Tainan Municipal Hospital, Tainan, Taiwan Department of Thoracic Surgery, Coruna University Hospital and Minimally Invasive Thoracic Surgery Unit, Coruna, Spain.
authors.forename: Jia-Ming
authors.initials: JM
authors.lastname: Chang
authors.forename: Kam-Hong
authors.initials: KH
authors.lastname: Kam
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Yen
authors.forename: Wei-Li
authors.initials: WL
authors.lastname: Huang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Yau-Lin
authors.initials: YL
authors.lastname: Tseng
authors.forename: Ming-Ho
authors.initials: MH
authors.lastname: Wu
authors.forename: Wu-Wei
authors.initials: WW
authors.lastname: Lai
authors.forename: Diego
authors.initials: D
authors.lastname: Gonzalez-Rivas
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013997:Time Factors