Single-port video-assisted thoracic surgery in 1063 cases: a single-institution experience

作者：Dong Xie, Haifeng Wang, Ke Fei, Chang Chen, Deping Zhao, Xiao Zhou, Boxiong Xie, Lei Jiang, Qiankun Chen, Nan Song, Jie Dai, Gening Jiang, Yuming Zhu · 发表于：European Journal of Cardio-Thoracic Surgery · 年份：2016 · DOI：10.1093/ejcts/ezv408 · 被引用次数：64 · 研究领域：Lung Cancer Diagnosis and Treatment、Minimally Invasive Surgical Techniques、Tracheal and airway disorders

OBJECTIVES: Single-port video-assisted thoracic surgery (VATS) technique has been used for thoracic diseases. There was no report about single-port VATS in large series. Outcomes following single-port VATS were analysed to determine its efficacy and safety. METHODS: From June 2012 to June 2014, 1063 single-port VATSs were performed by four surgeons. Patient demographics, perioperative parameters, histopathology and outcomes were analysed. RESULTS: There were 1063 patients (524 men and 539 women). The median age was 56.1 ± 8.7 years (range, 15-86 years). Lobectomy was performed in 569 patients, segmentectomy in 162, wedge resection in 264, pleural biopsy in 7, drainage of effusion in 20, pleural tumour resection in 5, mediastinal tumour resection in 54, mediastinal tumour biopsy in 2, bilobectomy in 7, sleeve lobectomy in 3 and pneumonectomy in 2. Synchronous bilateral single-port VATS was performed in 27 cases, whereas metachronous bilateral single-port VATS was performed in 5 cases. Pathological diagnoses included primary lung cancer in 635 cases, metastatic lung cancer in 19, mediastinal tumour in 56, pleural disease in 32 and benign pulmonary conditions in 353. Fifteen intraoperative vascular injuries were identified in 15 patients. The total conversion rate was 4.6%. The average operation time was 135 ± 31 min (range, 30-230 min), and the average blood loss was 117 ± 47 ml (range, 50-2000 ml). The median intensive care unit stay was 1 day (0-4 days). The postoperative hos...