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Published in: Journal of Cardiothoracic Surgery 1/2023

Open Access 01-12-2023 | Lung Cancer | Research

The three steps method for uniportal video-assisted thoracoscopic right upper lobectomy

Authors: Caiyang Liu, Ran Ran, Lei Luo, Xiaoliang Li, Gaohua Liu, Hong Shao, Ji Li

Published in: Journal of Cardiothoracic Surgery | Issue 1/2023

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Abstract

Background

The uniportal video-assisted thoracoscopic right upper lobectomy (UVATRUL), as a common procedure for thoracic surgeons, is difficult to manipulate and has some inherent challenges. To solve both of problems, we summarized a series of techniques as the three steps method and investigated its feasibility on the patients of right upper lung cancer.

Methods

Forty-eight patients with right upper lobe lung cancer who underwent the three steps method UVATRUL in our hospital from January 2020 to May 2022 were selected as the three steps method group. Forty-seven patients who underwent the traditional UVATRUL were selected as the traditional method group. The intraoperative condition and postoperative condition of the two groups were retrospectively analysed. Multiple linear regression analysis was carried out to analyze the relationship between positive results and surgical method.

Results

All patients had successfully completed their surgeries. There was no significant difference between the two groups in respect of intraoperative blood loss, rate of conversion, day one thoracic drainage volume, chest tube indwelling time, incidence of postoperative complications, number of lymph node, and postoperative hospital stay (P > 0.05). Operative time of the three steps method group was significantly shorter than the traditional method group (P < 0.001), and number of reloads used was also significantly less than the traditional method group (P = 0.014). Multiple linear regression analysis showed that operative time (β = − 0.470, P < 0.001), and number of reloads (β = − 0.254, P = 0.007) correlated with surgical method.

Conclusion

Compared with the traditional UVATRUL, the three steps method trims the surgery procedures, shortens the operative time, and reduces the use of reloads which makes it an effective procedure for UVATRUL.
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Literature
1.
go back to reference Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;6(2):169–90. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;6(2):169–90.
2.
go back to reference Lewis RJ. The role of video-assisted thoracic surgery for carcinoma of the lung: wedge resection to lobectomy by simultaneous individual stapling. Ann Thorac Surg. 1993;56:762.CrossRef Lewis RJ. The role of video-assisted thoracic surgery for carcinoma of the lung: wedge resection to lobectomy by simultaneous individual stapling. Ann Thorac Surg. 1993;56:762.CrossRef
3.
go back to reference Swanson SJ, Herndon JE, D’Amico TA, et al. Video-assisted thoracic surgery lobectomy: report of CALGB 39802—a prospective, multi-institution feasibility study. J Clin Oncol. 2007;25(31):4993–7.CrossRef Swanson SJ, Herndon JE, D’Amico TA, et al. Video-assisted thoracic surgery lobectomy: report of CALGB 39802—a prospective, multi-institution feasibility study. J Clin Oncol. 2007;25(31):4993–7.CrossRef
4.
go back to reference Rocco G. VATS and Uniportal VATS: a glimpse into the future. J Thorac Dis. 2013;5(Suppl 3):S174. Rocco G. VATS and Uniportal VATS: a glimpse into the future. J Thorac Dis. 2013;5(Suppl 3):S174.
5.
go back to reference McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg. 2015;47:912–5.CrossRef McElnay PJ, Molyneux M, Krishnadas R, et al. Pain and recovery are comparable after either uniportal or multiport video-assisted thoracoscopic lobectomy: an observation study. Eur J Cardiothorac Surg. 2015;47:912–5.CrossRef
6.
go back to reference Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg. 2005;28:43–6.CrossRef Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg. 2005;28:43–6.CrossRef
7.
go back to reference Tamura M, Shimizu Y, Hashizume Y. Pain following thoracoscopic surgery: retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. J Cardiothorac Surg. 2013;8:153.CrossRef Tamura M, Shimizu Y, Hashizume Y. Pain following thoracoscopic surgery: retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. J Cardiothorac Surg. 2013;8:153.CrossRef
8.
go back to reference Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg. 2004;77:726–8.CrossRef Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg. 2004;77:726–8.CrossRef
9.
go back to reference Gonzalez-Rivas D, Mendez L, Delgado M, et al. Uniportal video-assisted thoracoscopic anatomic segmentectomy. J Thorac Dis. 2013;5(Suppl 3):S226–33. Gonzalez-Rivas D, Mendez L, Delgado M, et al. Uniportal video-assisted thoracoscopic anatomic segmentectomy. J Thorac Dis. 2013;5(Suppl 3):S226–33.
10.
go back to reference Gonzalez-Rivas D, Delgado M, Fieira E, et al. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg. 2014;3:E2. Gonzalez-Rivas D, Delgado M, Fieira E, et al. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg. 2014;3:E2.
11.
go back to reference McKenna RJ Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg. 2006;81(02):421–5.CrossRef McKenna RJ Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg. 2006;81(02):421–5.CrossRef
12.
go back to reference Go´mez-Caro A, Calvo MJ, Lanzas JT, et al. The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy. Eur J Cardiothorac Surg. 2007;31:203e8.CrossRef Go´mez-Caro A, Calvo MJ, Lanzas JT, et al. The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy. Eur J Cardiothorac Surg. 2007;31:203e8.CrossRef
13.
go back to reference Liu L, Che G, Qiang P, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol. 2009;19(2):e71–7.CrossRef Liu L, Che G, Qiang P, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol. 2009;19(2):e71–7.CrossRef
14.
go back to reference He CJ, et al. Application and experience of single endoscopic linear cutter stapler through uniportal video-assisted thoracic surgery for lung cancer in right upper lobe. Oncol Progress. 2018;16(12):1518–21. He CJ, et al. Application and experience of single endoscopic linear cutter stapler through uniportal video-assisted thoracic surgery for lung cancer in right upper lobe. Oncol Progress. 2018;16(12):1518–21.
15.
go back to reference He J, Ma D, Li S. Uniportal video-assisted thoracoscopic right upper lobectomy and systemic mediastinal lymph nodes dissection. J Thorac Dis. 2017;9(6):1644.CrossRef He J, Ma D, Li S. Uniportal video-assisted thoracoscopic right upper lobectomy and systemic mediastinal lymph nodes dissection. J Thorac Dis. 2017;9(6):1644.CrossRef
16.
go back to reference Henschke CI, Yip R, Smith JP, et al. CT screening for lung cancer: part-solid nodules in baseline and annual repeat rounds. AJR Am J Roentgenol. 2016;207(6):1176–84.CrossRef Henschke CI, Yip R, Smith JP, et al. CT screening for lung cancer: part-solid nodules in baseline and annual repeat rounds. AJR Am J Roentgenol. 2016;207(6):1176–84.CrossRef
17.
go back to reference Paul S, Isaacs AJ, Treasure T, et al. Long term survival with thoracoscopic versus open lobectomy: propensity matched comparative analysis using SEER-Medicare database. BMJ. 2014;349:g5575.CrossRef Paul S, Isaacs AJ, Treasure T, et al. Long term survival with thoracoscopic versus open lobectomy: propensity matched comparative analysis using SEER-Medicare database. BMJ. 2014;349:g5575.CrossRef
18.
go back to reference Lee PC, Nasar A, Port JL, et al. Long-term survival after lobectomy for non-small cell lung cancer by video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg. 2013;96:951–60.CrossRef Lee PC, Nasar A, Port JL, et al. Long-term survival after lobectomy for non-small cell lung cancer by video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg. 2013;96:951–60.CrossRef
19.
go back to reference Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis. 2014;6:641–8. Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis. 2014;6:641–8.
20.
go back to reference Zhang L, Hao X. Video-assisted thoracic surgical right upper lobectomy with bronchus-first and simultaneous vessel stapling technique. Thorac Cardiovasc Surg. 2018;66(2):177–9.CrossRef Zhang L, Hao X. Video-assisted thoracic surgical right upper lobectomy with bronchus-first and simultaneous vessel stapling technique. Thorac Cardiovasc Surg. 2018;66(2):177–9.CrossRef
Metadata
Title
The three steps method for uniportal video-assisted thoracoscopic right upper lobectomy
Authors
Caiyang Liu
Ran Ran
Lei Luo
Xiaoliang Li
Gaohua Liu
Hong Shao
Ji Li
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2023
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-023-02129-0

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