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01-08-2021 | Pulmonary Nodule | Original Article

Transareolar uniportal video-assisted thoracoscopic surgery for the treatment of male patients with peripheral pulmonary nodules: a novel technique in thoracic surgery

Authors: Jianbo Lin, Yinhe Yin, Yi Zhuo, Xu Li, Fancai Lai

Published in: Updates in Surgery | Issue 4/2021

Abstract

In this study, we report the use of transareolar uniportal video-assisted thoracoscopic surgery (VATS) in thoracic surgery for the treatment of male patients with peripheral pulmonary nodules. From February 2014 to September 2018, 46 male patients with small PPNs underwent VATS, of whom 41 underwent unilateral VATS, and five underwent bilateral VATS. All procedures were successfully performed. Patients received 1 year of outpatient follow-up postoperatively. The data indicated that the average operation times were 32.7 min (unilateral) and 58.6 min (bilateral). The mean length of the incision was 2.7 ± 0.3 cm, with a mean cosmetic score of 3.2 ± 0.7 at the time of discharge. All patients rapidly recovered consciousness postoperatively. The length of postoperative hospitalization (LOH) was 3.4 ± 1.4 days. There was no obvious surgical scarring on the chest wall, and no patients complained of postoperative pain at 6 months postoperatively. No recurrence or metastasis was found during the 1-year follow-up. Transareolar uniportal VATS for peripheral pulmonary nodules resulted in good cosmetic outcomes and high patient satisfaction. Transareolar uniportal VATS is a safe and effective therapeutic procedure for male patients with small PPNs and especially produces good cosmetic outcomes.

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Yang SM, Wang ML, Hung MH, Hsu HH, Cheng YJ, Chen JS (2017) Tubeless uniportal thoracoscopic wedge resection for peripheral lung nodules. Ann Thorac Surg 103(2):462–468. https://doi.org/10.1016/j.athoracsur.2016.09.006CrossRefPubMed

Zheng H, Zhan Y, Liu S, Lu J, Luo J, Feng J, Fan S (2018) The roles of tumor-derived exosomes in non-small cell lung cancer and their clinical implications. J Exp Clin Cancer Res CR 37(1):226. https://doi.org/10.1186/s13046-018-0901-5CrossRefPubMed

Lin JB, Qiu ML, Lin CJ, Li X, Chen JF, Lai FC, Liu B (2019) Simplified synchronous disconnection of pulmonary arteries and veins for right upper lobectomy. Surg Endosc 33(6):2015–2023. https://doi.org/10.1007/s00464-018-06659-wCrossRefPubMed

Lin JB, Chen JF, Lai FC, Li X, Qiu ML (2016) Transareolar pulmonary bullectomy for primary spontaneous pneumothorax. J Thorac Cardiovasc Surg 152(4):999–1005. https://doi.org/10.1016/j.jtcvs.2016.06.023CrossRefPubMed

Salati M, Brunelli A, Xiumè F, Refai M, Sciarra V, Soccetti A, Sabbatini A (2008) Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg 7(1):63–66. https://doi.org/10.1510/icvts.2007.165712CrossRefPubMed

Tamura M, Shimizu Y, Hashizume Y (2013) Pain following thoracoscopic surgery: retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. J Cardiothorac Surg 8:153. https://doi.org/10.1186/1749-8090-8-153CrossRefPubMedPubMedCentral

Yang HC, Cho S, Jheon S (2013) Single-incision thoracoscopic surgery for primary spontaneous pneumothorax using the SILS port compared with conventional three-port surgery. Surg Endosc 27(1):139–145. https://doi.org/10.1007/s00464-012-2381-6CrossRefPubMed

Gonzalez-Rivas D, Paradela M, Fernandez R, Delgado M, Fieira E, Mendez L, Velasco C, de la Torre M (2013) Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg 95(2):426–432. https://doi.org/10.1016/j.athoracsur.2012.10.070CrossRefPubMed

Mier JM, Chavarin A, Izquierdo-Vidal C, Fibla JJ, Molins L (2013) A prospective study comparing three-port video-assisted thoracoscopy with the single-incision laparoscopic surgery (SILS) port and instruments for the video thoracoscopic approach: a pilot study. Surg Endosc 27(7):2557–2560. https://doi.org/10.1007/s00464-012-2782-6CrossRefPubMed

10.

Kawada M, Okubo T, Poudel S, Suzuki Y, Kawarada Y, Kitashiro S, Okushiba S, Katoh H (2013) A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method. Interact Cardiovasc Thorac Surg 16(3):381–383. https://doi.org/10.1093/icvts/ivs521CrossRefPubMed

11.

Konge L, Vilmann P, Clementsen P, Annema JT, Ringsted C (2012) Reliable and valid assessment of competence in endoscopic ultrasonography and fine-needle aspiration for mediastinal staging of non-small cell lung cancer. Endoscopy 44(10):928–933. https://doi.org/10.1055/s-0032-1309892CrossRefPubMed

12.

Kato H, Oizumi H, Suzuki J, Hamada A, Watarai H, Nakahashi K, Sadahiro M (2017) Thoracoscopic wedge resection and segmentectomy for small-sized pulmonary nodules. J Vis Surg 3:66. https://doi.org/10.21037/jovs.2017.03.22CrossRefPubMedPubMedCentral

13.

Zieliński M, Pankowski J, Hauer Ł, Kuzdzał J, Nabiałek T (2007) The right upper lobe pulmonary resection performed through the transcervical approach. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg 32(5):766–769. https://doi.org/10.1016/j.ejcts.2007.07.034CrossRef

14.

Doki Y, Ichiki K, Tsuda M, Toge M, Misaki T, Usuda K, Sugiyama S (2004) Complete port-accessed lobectomy by the muscle-sparing method. Ann Thorac Surg 77(6):2230–2231. https://doi.org/10.1016/s0003-4975(03)01157-3CrossRefPubMed

15.

Iwazaki M, Inoue H (2009) Microthoracoscopic one-port method for lung cancer. Ann Thorac Surg 87(4):1250–1252. https://doi.org/10.1016/j.athoracsur.2008.09.080CrossRefPubMed

16.

Oda M, Matsumoto I, Takizawa M, Waseda R, Suzuki M, Ishiyama Y, Abe T, Ishikawa N, Watanabe G (2013) Needlescopic video-assisted wedge resection combined with the subcostal trans-diaphragmatic approach for undetermined peripheral pulmonary nodules. Surg Endosc 27(10):3671–3677. https://doi.org/10.1007/s00464-013-2943-2CrossRefPubMed

17.

Chen JF, Lin M, Chen P, Quan D, Li X, Lai FC, Tu YR (2016) Nonintubated needlescopic thoracic sympathectomy for primary palmar hyperhidrosis: a randomized controlled trial. Surg Laparosc Endosc Percutaneous Tech 26(4):328–333. https://doi.org/10.1097/sle.0000000000000287CrossRef

18.

Tu YR, Lai FC, Li X, Lin M, Duan HB, Fu CG, Zhan HH, Zheng YW (2011) Trans-areola single port endoscopic thoracic sympathectomy for the treatment of palmar hyperhidrosis: a new surgical approach. Zhonghua yi xue za zhi 91(44):3131–3133PubMed

19.

Frey JD, Motosko CC, Moore K, Poudrier G, Hazen A (2019) A novel periareolar approach to chest wall reconstruction using a Nipple-Areola complex transposition flap. Plast Reconstr Surg 144(3):528e–530e. https://doi.org/10.1097/prs.0000000000005926CrossRefPubMed

20.

Xu K, Bian W, Xie H, Ma H, Ni B (2016) Single-port video-assisted thoracoscopic wedge resection: novel approaches in different genders. Interact Cardiovasc Thorac Surg 23(2):202–207. https://doi.org/10.1093/icvts/ivw119CrossRefPubMed

21.

Göttgens KW, Siebenga J, Belgers EH, van Huijstee PJ, Bollen EC (2011) Early removal of the chest tube after complete video-assisted thoracoscopic lobectomies. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg 39(4):575–578. https://doi.org/10.1016/j.ejcts.2010.08.002CrossRef

Title: Transareolar uniportal video-assisted thoracoscopic surgery for the treatment of male patients with peripheral pulmonary nodules: a novel technique in thoracic surgery
Authors: Jianbo Lin
Yinhe Yin
Yi Zhuo
Xu Li
Fancai Lai
Publication date: 01-08-2021
Publisher: Springer International Publishing
Keywords: Pulmonary Nodule
Incision
Published in: Updates in Surgery / Issue 4/2021
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00945-w

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Springer Medicine

Transareolar uniportal video-assisted thoracoscopic surgery for the treatment of male patients with peripheral pulmonary nodules: a novel technique in thoracic surgery

Abstract

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Springer Medicine

Abstract

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