Clinical efficacy of two micro-portal video-assisted thoracic surgery in pulmonary lobectomy for lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TONG Liping , ZHENG Xiaoqing , LIU Honggang , ZHU Yifang , LI Xiaofei ,  YAN Xiaolong

Department of Thoracic Surgery, Tangdu Hospital, The Air Force Medical University, Xi’an, 710038, P.R.China;

Corresponding?author：

YAN Xiaolong, Email: 47260934@qq.com

Keywords：

Two micro-port; video-assisted thoracic surgery; lung cancer; enhanced recovery after surgery

DOI：

10.7507/1007-4848.201807044

Video：

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Objective To analyze the surgical outcome of patients with lung cancer using double micro-portal video-assisted thoracic surgery (VATS) technique.Methods We retrospectively analyzed the perioperative data of 200 patients with primary lung cancer who underwent successful two micro-portal VATS lobectomy between September 2016 and June 2018 at our unit. There were 125 males and 75 females, aged 61.01±8.71 years. The length of the main operating hole was about 2.0–2.5 cm, the size of the secondary operating hole and the observation hole was 0.5 cm individually. Thus, the total length of the three incisions was 3.0–3.5 cm.Results The mean operating time was 99.18±21.77 min, blood loss was 170.35±105.12 ml, and the mean number of dissected lymph node was 15.82±3.33. The mean volume and duration of chest tube were 446.90±195.32 ml and 3.67±1.85 days. The postoperative hospital stay was 5.54±2.41 days. Only one patient died of pulmonary embolism after surgery. There were 7 patients who were converted to thoracotomy. Postoperative pulmonary infection after lobectomy was found in 8 patients. Postoperative air leak over 5 days was developed in 7 patients.Conclusion The double micro-portal VATS procedure is a safe and effective strategy for patients with lung cancer, which is associated with decreased surgical trauma and less postoperative pain. This emerging technology may benefit patients by enhancing comfort during their postoperative hospitalization.

Citation： TONG Liping, ZHENG Xiaoqing, LIU Honggang, ZHU Yifang, LI Xiaofei, YAN Xiaolong. Clinical efficacy of two micro-portal video-assisted thoracic surgery in pulmonary lobectomy for lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(4): 369-373. doi: 10.7507/1007-4848.201807044 Copy

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5.	Wang GS, Wang Z, Wang J, et al. Biportal complete video-assisted thoracoscopic lobectomy and systematic lymphadenectomy. J Thorac Dis, 2013, 5(6): 875-881.
6.	Gonzalez D, de la Torre M, Paradela M, et al. Video-assisted thoracic surgery lobectomy: 3-year initial experience with 200 cases. Eur J Cardiothorac Surg, 2011, 40(1): e21-e28.
7.	Liu C, Pu Q, Guo C, et al. Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery. BMC Surg, 2015, 15: 38.
8.	李彩偉, 徐美青, 徐廣文, 等. 單孔與三孔胸腔鏡肺部手術后急慢性疼痛的對比研究. 中國肺癌雜志, 2018, 21(4): 279-284.
9.	Detterbeck F, Molins L. Video-assisted thoracic surgery and open chest surgery in lung cancer treatment: present and future. J Vis Surg, 2016, 2: 173.
10.	Guerrero WG, González-Rivas D. Multiportal video-assisted thoracic surgery, uniportal video-assisted thoracic surgery and minimally invasive open chest surgery-selection criteria. J Vis Surg, 2017, 3: 56.
11.	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-e77.
12.	Harris CG, James RS, Tian DH, et al. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg, 2016, 5(2): 76-84.
13.	Xie D, Wang H, Fei K, et al. Single-port video-assisted thoracic surgery in 1063 cases: a single-institution experience. Eur J Cardiothorac Surg, 2016, 49(Suppl 1): i31-i36.
14.	Wang L, Liu D, Lu J, et al. The feasibility and advantage of uniportal video-assisted thoracoscopic surgery (VATS) in pulmonary lobectomy. BMC Cancer, 2017, 17(1): 75.
15.	車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Lemjabbar-Alaoui H, Hassan OU, Yang YW, et al. Lung cancer: Biology and treatment options. Biochim Biophys Acta, 2015, 1856(2): 189-210.
3. D’Andrilli A, Rendina EA. Enhanced recovery after surgery (ERAS) and fast-track in video-assisted thoracic surgery (VATS) lobectomy: preoperative optimisation and care-plans. J Vis Surg, 2018, 4: 4.
4. Borro JM, Regueiro F, Pértega S, et al. Comparative study of survival following videothoracoscopic lobectomy procedures for lung cancer: single- versus multiple-port approaches. Arch Bronconeumol, 2017, 53(4): 199-205.
5. Wang GS, Wang Z, Wang J, et al. Biportal complete video-assisted thoracoscopic lobectomy and systematic lymphadenectomy. J Thorac Dis, 2013, 5(6): 875-881.
6. Gonzalez D, de la Torre M, Paradela M, et al. Video-assisted thoracic surgery lobectomy: 3-year initial experience with 200 cases. Eur J Cardiothorac Surg, 2011, 40(1): e21-e28.
7. Liu C, Pu Q, Guo C, et al. Non-grasping en bloc mediastinal lymph node dissection for video-assisted thoracoscopic lung cancer surgery. BMC Surg, 2015, 15: 38.
8. 李彩偉, 徐美青, 徐廣文, 等. 單孔與三孔胸腔鏡肺部手術后急慢性疼痛的對比研究. 中國肺癌雜志, 2018, 21(4): 279-284.
9. Detterbeck F, Molins L. Video-assisted thoracic surgery and open chest surgery in lung cancer treatment: present and future. J Vis Surg, 2016, 2: 173.
10. Guerrero WG, González-Rivas D. Multiportal video-assisted thoracic surgery, uniportal video-assisted thoracic surgery and minimally invasive open chest surgery-selection criteria. J Vis Surg, 2017, 3: 56.
11. 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-e77.
12. Harris CG, James RS, Tian DH, et al. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg, 2016, 5(2): 76-84.
13. Xie D, Wang H, Fei K, et al. Single-port video-assisted thoracic surgery in 1063 cases: a single-institution experience. Eur J Cardiothorac Surg, 2016, 49(Suppl 1): i31-i36.
14. Wang L, Liu D, Lu J, et al. The feasibility and advantage of uniportal video-assisted thoracoscopic surgery (VATS) in pulmonary lobectomy. BMC Cancer, 2017, 17(1): 75.
15. 車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy of two micro-portal video-assisted thoracic surgery in pulmonary lobectomy for lung cancer

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