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World Journal of Surgery

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Open Access 01-07-2019 | Incision | Original Scientific Report

The Feasibility and Advantages of Subxiphoid Uniportal Video-Assisted Thoracoscopic Surgery in Pulmonary Lobectomy

Authors: Xueying Yang, Linlin Wang, Chenxi Zhang, Danyang Zhao, Yao Lu, Zelong Wang

Published in: World Journal of Surgery | Issue 7/2019

Abstract

Background

Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy has emerged as a promising and exciting approach for minimally invasive thoracic surgeries. However, nearly all reported uniportal VATS lobectomies are performed via an intercostal route, and chest wall trauma remains an issue. Here, we report the use of a novel uniportal VATS technique involving a subxiphoid route for pulmonary lobectomies.

Methods

We retrospectively analyzed perioperative data for patients who underwent subxiphoid uniportal and traditional three-port VATS lobectomies from January 2016 to January 2017 at our hospital.

Results

During the study period, 37 patients successively underwent subxiphoid uniportal VATS lobectomies, including three synchronous bilateral pulmonectomies; 68 patients underwent traditional three-port VATS. There were no surgical or 30-day postoperative mortalities, and no significant between-group differences were found in the number of retrieved lymph nodes, number of explored nodal stations, blood loss, drainage time, postoperative complications, or length of hospital stay. Operative time was longer in the subxiphoid uniportal VATS group than in the traditional three-port VATS group (P < 0.001). Visual analog scale (VAS) pain scores after surgery were significantly lower in the subxiphoid uniportal VATS group (P < 0.05).

Conclusions

Subxiphoid uniportal VATS lobectomy is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional VATS. Moreover, this procedure is better suited for patients receiving synchronous bilateral pulmonectomy. Further long-term follow-up analyses involving more patients are ongoing.

Trial registry number

ClinicalTrials.gov NCT03051438.

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Title: The Feasibility and Advantages of Subxiphoid Uniportal Video-Assisted Thoracoscopic Surgery in Pulmonary Lobectomy
Authors: Xueying Yang
Linlin Wang
Chenxi Zhang
Danyang Zhao
Yao Lu
Zelong Wang
Publication date: 01-07-2019
Publisher: Springer International Publishing
Keyword: Incision
Published in: World Journal of Surgery / Issue 7/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-04948-6

At a glance: The STEP trials

Springer Medicine

The Feasibility and Advantages of Subxiphoid Uniportal Video-Assisted Thoracoscopic Surgery in Pulmonary Lobectomy

Abstract

Background

Methods

Results

Conclusions

Trial registry number

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registry number

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