Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Peripheral Non-small Cell Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GAOYong-shan ¹ , XUEZhan-xia ² , DONGYue-hua ¹ , WANGDa-wei ¹ , YANGYan-jun ¹ , WEIYu-lei ¹ , JIANGWei-hua ¹ ,  ZHANGZhen-ming ¹

1. Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000 Hebei, P. R. China;
2. Department of Pharmacology, Hebei North University, Zhangjiakou 075000 Hebei, P. R. China;

Corresponding?author：

ZHANGZhen-ming, Email: m18231372816@163.com

Keywords：

Lobectomy; Lung cancer; Single utility port; Video-assisted thoracic surgery (VATS)

DOI：

10.7507/1007-4848.20160266

Video：

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Objective To evaluate clinical outcomes of single utility port video-assisted thoracoscopic surgery (VATS) lobectomy for patients with early-stage peripheral non-small cell lung cancer. Methods We retrospectively analyzed the clinical data of 46 consecutive patients with early-stage peripheral non-small cell lung cancer who underwent single utility port complete VATS lobectomy in the First Affiliated Hospital of Hebei north University from December 2012 through November 2014. There were 39 male patients and 7 female patients with their age of 42-76 (60.26±4.38) years (VATS group). There were 58 patients with early-stage peripheral non-small cell lung cancer who underwent lobectomy via traditional thoracotomy including 47 male and 11 female patients with their age of 44-73 (61.42±3.67) years for the same period (conventional thoracotomy group). Clinical outcomes were compared between the two groups. Results All the operations were successful. There was no conversions during single utility port VATS lobectomy, and no periopera-tive death in both groups. The VATS group had significantly less blood loss (126.10±48.56 ml vs. 260.84±69.70 ml), and amount of thoracic drainage (230.52±50.22 ml vs. 380.16±96.24 ml, P<0.05). Hospital stay was significantly shorter in the VATS group than the conventional thoracotomy group (6.42±1.40 days vs. 9.64±2.08 days, P<0.05). However, there was no significant difference between the VATS group and the conventional thoracotomy group with regard to the opera-ting time (146.25±19.68 minutes vs. 139.26±25.39 minutes), number of lymph nodes procured (13.56±2.31 vs. 14.12±3.06), and postoperative complications (13.0% vs. 19.0%, P>0.05). Conclusion Single utility port VATS lobectomy for patients with early-stage peripheral non-small cell lung cancer is technically feasible, with less blood loss and shorter hospital stays for achieving acceptable standards of lymph node dissection. It is a promising surgical procedures for patients with early-stage peripheral non-small cell lung cancer.

Citation： GAOYong-shan, XUEZhan-xia, DONGYue-hua, WANGDa-wei, YANGYan-jun, WEIYu-lei, JIANGWei-hua, ZHANGZhen-ming. Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Peripheral Non-small Cell Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(12): 1132-1135. doi: 10.7507/1007-4848.20160266 Copy

1.	初向陽，薛志強，劉毅，等.單操作孔電視胸腔鏡肺葉切除術治療早期肺癌的臨床研究.中國胸心血管外科臨床雜志, 2012, 19(2): 113-115.
2.	Ilonen IK1, R?s?nen JV, Knuuttila A, et al. Anatomic thoracoscopic lung resection for non-small cell lung cancer in stage I is associated with less morbidity and shorter hospitalization than thoracotomy. Acta Oncol, 2011, 50(7): 1126-1132.
3.	Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-77.
4.	劉倫旭, 車國衛, 蒲強, 等. 單向式全胸腔鏡肺葉切除術. 中華胸心血管外科雜志, 2008, 24(3): 156-158.
5.	蔡海波, 李迎新, 張士法, 等. 完全電視胸腔鏡肺葉切除術治療早期肺癌的近期療效評價. 中國胸心血管外科臨床雜志, 2014, 21(2): 224-227.
6.	李暢, 馬海濤, 何靖康, 等.單操作孔肺葉切除術治療周圍型肺癌的臨床研究. 中國肺癌雜志, 2013, 16(9): 487-491.
7.	鄭軼峰, 姜建青, 楊列, 等. 全胸腔鏡肺葉切除術60例臨床分析. 中國胸心血管外科臨床雜志, 2013, 20(2): 172-175.
8.	McKenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-426.
9.	West D, Rashid S, Dunning J. Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobec-tomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg, 2007, 6(1): 110-116.
10.	蔣偉, 奚俊杰, 王群, 等. 全胸腔鏡肺癌根治術淋巴結清掃的探討. 中國微創外科雜志, 2012, 12(11): 969-972.
11.	Kim HK, Choi Ys, Kim J, et al. Outcomes of unexpected pathologic N1 and N2 disease after video-assisted thoracic surgery lobectomy for clinical stage I non-small cell lung cancer. J Thorac Cardiovasc Surg, 2010, 140(6): 1288-1293.
12.	Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
13.	黃佳, 趙曉菁, 林皓, 等. 單向四孔法全胸腔鏡肺葉切除術治療非小細胞肺癌的臨床研究. 中國胸心血管外科臨床雜志, 2012, 19(2): 125-129.
14.	車國衛, 梅龍勇, 梅建東, 等. 單操作孔電視胸腔鏡手術治療肺部疾病158例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(2): 116-119.
15.	車國衛, 劉倫旭. 單孔電視胸腔鏡手術臨床應用的現狀與進展. 中國胸心血管外科臨床雜志, 2012, 19(2): 181-184.
16.	初向陽, 薛志強, 張連斌, 等. 單操作孔胸腔鏡肺葉切除術的初步報道. 中國肺癌雜志, 2010, 13(1): 19-21.
17.	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(1): 43-46.
18.	王光宇, 初向陽, 李國, 等. 單操作孔電視胸腔鏡與開胸肺癌根治術對早期肺癌淋巴結清掃及療效的對比研究. 中國醫藥, 2014, 1(9): 37-40.
19.	王光宇, 初向陽, 李國, 等. 單操作孔電視胸腔鏡肺葉切除術的學習曲線研究. 中國醫藥, 2014, 9(5): 642-644.
20.	蒲強, 車國衛, 劉倫旭, 等. 單向式全胸腔鏡肺癌切除術的學習曲線分析. 中華外科雜志, 2010, 48(15): 1161-1165.

1. 初向陽，薛志強，劉毅，等.單操作孔電視胸腔鏡肺葉切除術治療早期肺癌的臨床研究.中國胸心血管外科臨床雜志, 2012, 19(2): 113-115.
2. Ilonen IK1, R?s?nen JV, Knuuttila A, et al. Anatomic thoracoscopic lung resection for non-small cell lung cancer in stage I is associated with less morbidity and shorter hospitalization than thoracotomy. Acta Oncol, 2011, 50(7): 1126-1132.
3. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-77.
4. 劉倫旭, 車國衛, 蒲強, 等. 單向式全胸腔鏡肺葉切除術. 中華胸心血管外科雜志, 2008, 24(3): 156-158.
5. 蔡海波, 李迎新, 張士法, 等. 完全電視胸腔鏡肺葉切除術治療早期肺癌的近期療效評價. 中國胸心血管外科臨床雜志, 2014, 21(2): 224-227.
6. 李暢, 馬海濤, 何靖康, 等.單操作孔肺葉切除術治療周圍型肺癌的臨床研究. 中國肺癌雜志, 2013, 16(9): 487-491.
7. 鄭軼峰, 姜建青, 楊列, 等. 全胸腔鏡肺葉切除術60例臨床分析. 中國胸心血管外科臨床雜志, 2013, 20(2): 172-175.
8. McKenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-426.
9. West D, Rashid S, Dunning J. Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobec-tomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg, 2007, 6(1): 110-116.
10. 蔣偉, 奚俊杰, 王群, 等. 全胸腔鏡肺癌根治術淋巴結清掃的探討. 中國微創外科雜志, 2012, 12(11): 969-972.
11. Kim HK, Choi Ys, Kim J, et al. Outcomes of unexpected pathologic N1 and N2 disease after video-assisted thoracic surgery lobectomy for clinical stage I non-small cell lung cancer. J Thorac Cardiovasc Surg, 2010, 140(6): 1288-1293.
12. Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
13. 黃佳, 趙曉菁, 林皓, 等. 單向四孔法全胸腔鏡肺葉切除術治療非小細胞肺癌的臨床研究. 中國胸心血管外科臨床雜志, 2012, 19(2): 125-129.
14. 車國衛, 梅龍勇, 梅建東, 等. 單操作孔電視胸腔鏡手術治療肺部疾病158例臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(2): 116-119.
15. 車國衛, 劉倫旭. 單孔電視胸腔鏡手術臨床應用的現狀與進展. 中國胸心血管外科臨床雜志, 2012, 19(2): 181-184.
16. 初向陽, 薛志強, 張連斌, 等. 單操作孔胸腔鏡肺葉切除術的初步報道. 中國肺癌雜志, 2010, 13(1): 19-21.
17. 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(1): 43-46.
18. 王光宇, 初向陽, 李國, 等. 單操作孔電視胸腔鏡與開胸肺癌根治術對早期肺癌淋巴結清掃及療效的對比研究. 中國醫藥, 2014, 1(9): 37-40.
19. 王光宇, 初向陽, 李國, 等. 單操作孔電視胸腔鏡肺葉切除術的學習曲線研究. 中國醫藥, 2014, 9(5): 642-644.
20. 蒲強, 車國衛, 劉倫旭, 等. 單向式全胸腔鏡肺癌切除術的學習曲線分析. 中華外科雜志, 2010, 48(15): 1161-1165.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Peripheral Non-small Cell Lung Cancer

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