A propensity matched comparison of effects between video assisted thoracoscopic single-port, two-port and three-port pulmonary resection on lung cancer

Mu, Jianjun; Gao, Shugeng; Xue, Qi; Mao, Yousheng; Wang, Dali; Zhao, Jun; Gao, Yushun; Huang, Jinfeng; He, Jie

doi:10.21037/jtd.2016.05.64

Cited by 18 publications

(14 citation statements)

References 25 publications

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“…Every type, from minor and intermediate procedures to more complex procedures has been described over the past few years. [ 7 , 10 , 18 ] Although a series of retrospective studies has shown that single-port VATS is superior to the traditional VATS approach in terms of early outcomes [ 6 , 7 , 19 ] (i.e., postoperative pain, chest tube drainage, and hospital stay) and have emphasized the feasibility and safety of this procedure, there has always been some skepticism about treatment and oncological results. Preliminary reports on single-port VATS have led to many discussions and eliminated some of the doubts of opponents, [ 6 – 9 ] but suspicions or criticism regarding the potential compromise of oncological results or patients’ postoperative morbidity and mortality still remained.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of postoperative complications in single-port video-assisted thoracoscopic anatomical resection

González-Rivas

Kuo

et al. 2018

Medicine

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The purpose of this study was to identify the risk factors for adverse events during single-port video-assisted thoracoscopic (SPVATS) anatomical resections.We retrospectively reviewed patients who had undergone SPVATS anatomic resections between January 2014 and February 2017 in Coruña University Hospital's Minimally Invasive Thoracic Surgery Unit (CHUAC, Spain) and Chang Gung Memorial Hospital (CGMH, Taiwan). Four hundred forty-two patients (male: 306, female: 136) were enrolled in this study. Logistic regression analysis was performed on variables for postoperative complications.Postoperative complications with a 30-day mortality occurred in 94 patients (21.3%) and with a 90-day mortality in 3 patients (0.7%) while the major complication rate was 3.9%. Prolonged air leak (PAL > 5 days) was the most common complication and came by postoperative arrhythmia. Logistic regression indicated that pleural symphysis (odds ratio (OR), 1.91; 95% confidence interval (CI), 1.14–3.18; P = .014), computed tomography (CT) pulmonary emphysema (OR, 2.63; 95% CI, 1.41–4.76; P = .002), well-developed pulmonary CT fissure line (OR, 0.49; 95% CI, 0.29–0.84; P = .009), and tumor size (≥3 cm) (OR, 2.15; 95% CI, 1.30–3.57; P = .003) were predictors of postoperative complications.Our preliminary results revealed that SPVATS anatomic resection achieves acceptable 30- and 90-day surgery related mortality (0.7%) and major complications rate (3.9%). Prolonged Air leak (PAL > 5 days) was the most common postoperative complication. Pleural symphysis, pulmonary emphysema, well-developed pulmonary CT fissure line and tumor size (≥3 cm) were predictors of adverse events during SPVATS anatomic resection.

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Section: Discussionmentioning

confidence: 99%

Predictive factors of postoperative complications in single-port video-assisted thoracoscopic anatomical resection

González-Rivas

Kuo

et al. 2018

Medicine

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“…The perioperative outcomes of a single-port, two-port, and three-port approaches were studied. Recent study has shown that VATS single-port and two-port pulmonary resection were associated with decreased volume of drainage, shorter length of stay, and shorter duration of chest drainage ( 33 ). However, further randomized controlled trials with larger number of patients are needed to confirm the beneficial effects of single-port compared to three-port VATS pulmonary resections.…”

Section: Intraoperative Phasementioning

confidence: 99%

Enhanced Recovery in Thoracic Surgery: A Review

et al. 2018

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The main goal of enhanced recovery program after thoracic surgery is to minimize stress response, reduce postoperative pulmonary complications, and improve patient outcome, which will in addition decrease hospital stay and reduce hospital costs. As minimally invasive technique, video-assisted thoracoscopic surgery represents an important element of enhanced recovery program in thoracic surgery. Anesthetic management during preoperative, intraoperative and postoperative period is essential for the enhanced recovery. In the era of enhanced recovery protocols, non-intubated thoracoscopic procedures present a step forward. This article focuses on the key elements of the enhanced recovery program in thoracic surgery. Having reviewed recent literature, the authors highlight potential procedures and techniques that might be incorporated into the program.

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“…decreased operating time, conversion rate and air leak) after 90 procedures [24]. Simulation training may shorten the learning curve [25]. Surgical trainees may be directly oriented towards minimally invasive technique without extensive experience in open surgery [26], and VATS should be taught in any accredited training programme.…”

Section: A Thoracic Surgeon's Perspective (G Massard)mentioning

confidence: 99%

Pain control in thoracic oncology

et al. 2017

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This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert.In the USA, Europe and other countries, palliative care specialists often become rapidly involved in the management of these patients, coordinating social care and providing psychological support.Thoracic and orthopaedic spine subspecialists provide surgical methods to control tumour invasion, and improve quality of life and preservation of function in settings of even diffuse metastatic disease. Similarly, thoracic oncology and radiation therapists utilise both therapeutic and palliative chemotherapeutic and radiation therapy regimens to prolong and improve quality of life.The pain medicine specialist can, in addition to medication management, offer a variety of interventional approaches including unique drug delivery systems such as epidural analgesia, regional anaesthesia techniques, and intrathecal pumps, as well as neuromodulation techniques and neurolytic or neuroablative procedures.In the USA, these specialists complete an additional fellowship year in pain medicine following the completion of an anaesthesiology, physical medicine and rehabilitation, neurology or psychiatry residency. These programmes are accredited by the Accreditation Council for Graduate Medical Education, or ACGME (www.acgme.org).

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A propensity matched comparison of effects between video assisted thoracoscopic single-port, two-port and three-port pulmonary resection on lung cancer

Cited by 18 publications

References 25 publications

Predictive factors of postoperative complications in single-port video-assisted thoracoscopic anatomical resection

Predictive factors of postoperative complications in single-port video-assisted thoracoscopic anatomical resection

Enhanced Recovery in Thoracic Surgery: A Review

Pain control in thoracic oncology

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