Journal of Chest Surgery

  • 제50권5호
  • /
  • Pages.339-345
  • /
  • 2017
  • /
  • 2765-1606(pISSN)
  • /
  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지
DOI QR코드

DOI QR Code

Efficacy of Single-Port Video-Assisted Thoracoscopic Surgery Lobectomy Compared with Triple-Port VATS by Propensity Score Matching

  • Song, Kyung Sub (Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Park, Chang Kwon (Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Jae Bum (Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine)
  • 투고 : 2016.12.12
  • 심사 : 2017.03.29
  • 발행 : 2017.10.05
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: In recent years, single-port video-assisted thoracoscopic surgery (VATS) for lobectomy in non-small cell lung cancer (NSCLC) patients has become increasingly common. The objective of this study was to compare the feasibility and safety of single-port and triple-port VATS lobectomy. Methods: A total of 73 patients with NSCLC who underwent VATS lobectomy from December 2011 to August 2016 were retrospectively reviewed, including 47 in the triple-port group and 26 in the single-port group. Statistical analysis was performed after propensity score matching. Patients were matched on a 1-to-1 basis. Results: Operative time and intraoperative blood loss in the triple-port group and the single-port group were similar ($189.4{\pm}50.8minutes$ vs. $205.4{\pm}50.6minutes$, p=0.259; $286.5{\pm}531.0mL$ vs. $314.6{\pm}513.1mL$, p=0.813). There were no cases of morbidity or mortality. No significant differences in complications or the total number of dissected lymph nodes were found between the 2 groups. In the single-port group, more mediastinal lymph nodes were dissected than in the triple-port group ($1.7{\pm}0.6$ vs. $1.2{\pm}0.5$, p=0.011). Both groups had 1 patient with bronchopleural fistula. Chest tube duration and postoperative hospital stay were shorter in the single-port group than in the triple-port group ($8.7{\pm}5.1days$ vs. $6.2{\pm}6.6days$, p=0.130; $11.7{\pm}6.1days$ vs. $9.5{\pm}6.4days$, p=0.226). However, the differences were not statistically significant. In the single-port group, the rate of conversion to multi-port VATS lobectomy was 11.5% (3 of 26). The rates of conversion to open thoracotomy in the triple-port and single-port groups were 7.7% and 3.8%, respectively (p=1.000). Conclusion: In comparison with the triple-port group, single-port VATS lobectomy showed similar results in safety and efficacy, indicating that single-port VATS lobectomy is a feasible and safe option for lung cancer patients.

키워드

참고문헌

  1. 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:e21-8. https://doi.org/10.1016/j.ejcts.2011.02.051
  2. Shen Y, Wang H, Feng M, Xi Y, Tan L, Wang Q. Single- versus multiple-port thoracoscopic lobectomy for lung cancer: a propensity-matched study. Eur J Cardiothorac Surg 2016;49 Suppl 1:i48-53.
  3. Han KN, Kim HK, Choi YH. Comparison of single port versus multiport thoracoscopic segmentectomy. J Thorac Dis 2016;8(Suppl 3):S279-86.
  4. Zhu Y, Liang M, Wu W, et al. Preliminary results of single-port versus triple-port complete thoracoscopic lobectomy for non-small cell lung cancer. Ann Transl Med 2015;3:92.
  5. Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg 2013;95:426-32. https://doi.org/10.1016/j.athoracsur.2012.10.070
  6. Hirai K, Takeuchi S, Usuda J. Single-port video-assisted thoracic surgery for early lung cancer: initial experience in Japan. J Thorac Dis 2016;8(Suppl 3):S344-50.
  7. Wang BY, Tu CC, Liu CY, Shih CS, Liu CC. Single-incision thoracoscopic lobectomy and segmentectomy with radical lymph node dissection. Ann Thorac Surg 2013;96:977-82. https://doi.org/10.1016/j.athoracsur.2013.05.002
  8. Kang DK, Min HK, Jun HJ, Hwang YH, Kang MK. Single-port video-assisted thoracic surgery for lung cancer. Korean J Thorac Cardiovasc Surg 2013;46:299-301. https://doi.org/10.5090/kjtcs.2013.46.4.299
  9. Daniels LJ, Balderson SS, Onaitis MW, D'Amico TA. Thoracoscopic lobectomy: a safe and effective strategy for patients with stage I lung cancer. Ann Thorac Surg 2002;74:860-4. https://doi.org/10.1016/S0003-4975(02)03764-5
  10. Swanson SJ, Herndon JE 2nd, D'Amico TA, et al. Video-assisted thoracic surgery lobectomy: report of CALGB 39802: a prospective, multi-institution feasibility study. J Clin Oncol 2007;25:4993-7. https://doi.org/10.1200/JCO.2007.12.6649
  11. McKenna RJ Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 2006;81:421-5. https://doi.org/10.1016/j.athoracsur.2005.07.078
  12. Hansen HJ, Petersen RH. A video-atlas of video-assisted thoracoscopic lobectomy using a standardized three-port anterior approach. Ann Cardiothorac Surg 2012;1:104.
  13. Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 2004;77:726-8. https://doi.org/10.1016/S0003-4975(03)01219-0
  14. Landreneau RJ, Mack MJ, Hazelrigg SR, et al. Video-assisted thoracic surgery: basic technical concepts and intercostal approach strategies. Ann Thorac Surg 1992;54:800-7. https://doi.org/10.1016/0003-4975(92)91040-G
  15. Roviaro G, Rebuffat C, Varoli F, Vergani C, Mariani C, Maciocco M. Videoendoscopic pulmonary lobectomy for cancer. Surg Laparosc Endosc 1992;2:244-7.
  16. Wang BY, Liu CY, Hsu PK, Shih CS, Liu CC. Single-incision versus multiple-incision thoracoscopic lobectomy and segmentectomy: a propensity-matched analysis. Ann Surg 2015;261:793-9. https://doi.org/10.1097/SLA.0000000000000712
  17. Gonzalez-Rivas D, de la Torre M, Fernandez R, Garcia J. Video: single-incision video-assisted thoracoscopic right pneumonectomy. Surg Endosc 2012;26:2078-9. https://doi.org/10.1007/s00464-011-2127-x
  18. Gonzalez-Rivas D, Delgado M, Fieira E, Fernandez R. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg 2014;3:E2.
  19. Gonzalez-Rivas D, Fernandez R, Fieira E, Mendez L. Single-incision thoracoscopic right upper lobectomy with chest wall resection by posterior approach. Innovations (Phila) 2013;8:70-2. https://doi.org/10.1097/IMI.0b013e3182852005
  20. 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;5:76-84. https://doi.org/10.21037/acs.2016.03.17

피인용 문헌

  1. Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis vol.14, pp.2, 2017, https://doi.org/10.1177/1556984519837027
  2. Comparison of Uniportal versus Multiportal Video-Assisted Thoracoscopic Surgery Pulmonary Segmentectomy vol.52, pp.3, 2017, https://doi.org/10.5090/kjtcs.2019.52.3.141
  3. Uniportal video-assisted thoracoscopy surgery in lung cancer: largest experience vol.27, pp.7, 2017, https://doi.org/10.1177/0218492319868651
  4. A novel suction-based lung-stabilizing device in single-port video-assisted thoracoscopic surgical procedures vol.68, pp.5, 2017, https://doi.org/10.1007/s11748-019-01249-6
  5. Standardized surgical technique for uniportal video-assisted thoracoscopic lobectomy vol.58, pp.suppl1, 2020, https://doi.org/10.1093/ejcts/ezaa110
  6. Uniportal versus three‐port video‐assisted thoracoscopic surgery for non‐small cell lung cancer: A retrospective study vol.12, pp.8, 2017, https://doi.org/10.1111/1759-7714.13882