Single utility port or single port complete video-assisted thoracoscopic surgery for pulmonary lobectomy

A Comparison of Operative Outcomes between Single-Port and Multi-Port Video-Assisted Thoracoscopic Surgery (VATS) in Pulmonary Lobectomy

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.10.10696 ◽

2020 ◽

Vol 103 (10) ◽

pp. 1011-1016

Keyword(s):

Surgical Outcomes ◽

Rating Scale ◽

Single Port ◽

Thoracoscopic Surgery ◽

Patient Characteristics ◽

Perioperative Outcomes ◽

Safe Procedure ◽

Pulmonary Lobectomy ◽

Video Assisted ◽

Video Assisted Thoracoscopic Surgery

Background: Single-port video-assisted thoracoscopic surgery (VATS) have been performed in Southeast Asian countries for several years. However, the outcomes of the single-port VATS are still under investigation. Objective: To compare the surgical outcomes between single-port VATS and multi-port VATS in pulmonary lobectomy and to validate its efficacy and safety. Materials and Methods: The outcomes of 130 patients that underwent VATS at the Central Chest Institute of Thailand between January 2015 and May 2018, were reviewed. Patients were classified into two groups, single-port, and multi-port VATS with 68 as single-port and 62 as multi-port cases. Patient characteristics and perioperative outcomes were analyzed and compared. Results: There were no significant differences in patient characteristics between the two groups. The single-port group had a lower Pain Numeric Rating Scale at 24 hours (p=0.022) and shorter length of hospital stay (p=0.044) than the multi-port group. The number of N2 lymph nodes retrieved in the single-port group was significantly higher than in the multi-port group (p=0.022) while other surgical outcomes were not significantly different. There were no significant differences in intraoperative and post-operative complications (p=0.338 and p=0.142, respectively) and no perioperative mortality in both groups. Conclusion: The authors’ experience showed that single-port VATS is a practical technique and safe procedure when compared to multi-port VATS. Keywords: Video-assisted thoracoscopic surgery (VATS), lobectomy, minimally invasive surgery

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Robotic pulmonary lobectomy for lung cancer treatment: program implementation and initial experience

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562015000000212 ◽

2016 ◽

Vol 42 (3) ◽

pp. 185-190 ◽

Cited By ~ 6

Author(s):

Ricardo Mingarini Terra ◽

Pedro Henrique Xavier Nabuco de Araujo ◽

Leticia Leone Lauricella ◽

José Ribas Milanez de Campos ◽

Herbert Felix Costa ◽

...

Keyword(s):

Robotic Surgery ◽

Thoracic Surgery ◽

Thoracoscopic Surgery ◽

Sao Paulo ◽

Pathological Examination ◽

São Paulo ◽

Pulmonary Lobectomy ◽

Video Assisted ◽

Tertiary Teaching ◽

Video Assisted Thoracoscopic Surgery

ABSTRACT Objective: To describe the implementation of a robotic thoracic surgery program at a public tertiary teaching hospital and to analyze its initial results. Methods: This was a planned interim analysis of a randomized clinical trial aimed at comparing video-assisted thoracoscopic surgery and robotic surgery in terms of the results obtained after pulmonary lobectomy. The robotic surgery program developed at the Instituto do Câncer do Estado de São Paulo, in the city of São Paulo, Brazil, is a multidisciplinary initiative involving various surgical specialties, as well as anesthesiology, nursing, and clinical engineering teams. In this analysis, we evaluated the patients included in the robotic lobectomy arm of the trial during its first three months (from April to June of 2015). Results: Ten patients were included in this analysis. There were eight women and two men. The mean age was 65.1 years. All of the patients presented with peripheral tumors. We performed right upper lobectomy in four patients, right lower lobectomy in four, and left upper lobectomy in two. Surgical time varied considerably (range, 135-435 min). Conversion to open surgery or video-assisted thoracoscopic surgery was not necessary in any of the cases. Intraoperative complications were not found. Only the first patient required postoperative transfer to the ICU. There were no deaths or readmissions within the first 30 days after discharge. The only postoperative complication was chest pain (grade 3), in two patients. Pathological examination revealed complete tumor resection in all cases. Conclusions: When there is integration and proper training of all of the teams involved, the implementation of a robotic thoracic surgery program is feasible and can reduce morbidity and mortality.

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