Single-port thoracoscopic surgery can be a first-line approach for elective thoracoscopic surgery

Chen, C.-H.; Chang, Ho; Lee, S.-Y.; Liu, H.-C.; Hung, Tzu-Ti; Huang, Wen‐Chien

doi:10.1016/j.rppneu.2012.05.001

Cited by 7 publications

(8 citation statements)

References 10 publications

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“…Some authors defined that length of single port was less than 3.5 cm [16]. But there is no consensus on the length of single incision to be considered as SITS.…”

Section: Discussionmentioning

confidence: 99%

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Clinical application of single incision thoracoscopic surgery: early experience of 264 cases

Song

Yum

Choi

et al. 2014

J Cardiothorac Surg

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BackgroundSingle incision thoracoscopic surgery (SITS) is recognized as a difficult procedure and surgeons hesitate to perform this technique. We describe our experience of SITS and determine whether SITS can be a routine approach in minimally invasive surgery.MethodsFrom May 2011 to April 2013, a single operator attempted SITS for 264 cases. Their medical records were retrospectively reviewed with regard to age, sex, diagnosis, operation time, hospital stay, need of additional incision, morbidity, and early outcome.ResultsA number of thoracic diseases and procedures were attempted with SITS including primary (n = 172) or secondary (n = 22) spontaneous pneumothorax, biopsy for lung (n = 29), pleura (n = 3), and mediastinal lymph node (n = 3), mediastinal mass excision (n = 11), empyema decortication (n = 11), lobectomy (n = 6), pulmonary metastasectomy (n = 3), pericardial window formation (n = 3), and hematoma evacuation (n = 1). Of these, 237 cases underwent SITS successfully. However, additional incision was needed in 10.2% (n = 27). Reasons for conversions were as follows: extensive pleural adhesion (n = 14), difficulty in endoscopic stapling (n = 11), bleeding (n = 1), and intolerance of one lung ventilation (n = 1). Conversion rate of empyema was 54.5%, which was the most difficult for SITS. In contrast, the conversion rate of PSP was 4.7%, which means PSP was the most applicable for SITS. Postoperative complications included air leak (≥3 days) (n = 1), wound problem (n = 4), delayed pleural effusion (n = 1), and postoperative bleeding (n = 1).ConclusionsSITS can be a routine approach from simple to more complicated diseases. However, we still have difficulties in cases with extensive pleural adhesion or location of lesion with difficult accessibility for endoscopic stapling.

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“…Some authors defined that length of single port was less than 3.5 cm [16]. But there is no consensus on the length of single incision to be considered as SITS.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of SITS over the 3-port VATS are less pain, less paresthesia, and higher satisfaction rate for wound scar [5-12,14,16]. Despite of these advantages, there are still very limited numbers of surgeons who perform SITS.…”

Section: Discussionmentioning

confidence: 99%

Clinical application of single incision thoracoscopic surgery: early experience of 264 cases

Song

Yum

Choi

et al. 2014

J Cardiothorac Surg

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“…Such techniques had been proposed in the treatment of lung cancer, mediastinal tumor, pneumothorax and most common disease of the chest. [1][2][3][4][5] With modifications of conventional thoracoscopic techniques, the operative field can be extended to the contralateral side of the pleural space. In the case we presented, peel formation and loculations were mainly located in right side pleural space while the left side effusion was relatively free-floating.…”

Section: Commentmentioning

confidence: 99%

“…Although the adequacy of single-port approach is to be determined, the techniques of single-port approach in thoracoscopic surgery were shown to be feasible and safe in some recent studies. [1][2][3][4] In our team, single-port thoracoscopic approach had become our first-line approach since 2010. However, bilateral thoracoscopic surgery through unilateral single-port wound had not been reported.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Bilateral Empyema Thoracis Using Unilateral Single-Port Thoracoscopic Approach

Chen

Lin

Chang

et al. 2014

ATCS

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A variety of disease in the chest can be treated with thoracoscopic surgery. Although with limited experience, thoracoscopic surgery can be performed with single-port approach. Theoretically, single-port approach can be applied in treating bilateral pleural effusions. Here we reported a case of 28-year-old man with the diagnosis of septic embolization of the lung with complications of bilateral empyema. He was treated with single-port thoracoscopic surgery for decortication of right pleural space and deloculation of left pleural space. After prolonged course of antibiotics for 21 days, the patient was discharged. After follow-up for 3 months, the patient recovered well and had no evidence of recurrence.

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“…http://jsms.sch.ac.kr 이 대상이었으나 최근에는 그 적응증이 종격동 종양, 폐암 등으로 확대되고 있다 [1,[5][6][7][8][9][10][11][12]. 그러나…”

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A Study into the Potential for Safe Application of Single-Incision Thoracoscopic Surgery in Various Thoracic Diseases

Song¹,

Lee

2015

Soonchunhyang Med Sci

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Objective: Single-incision thoracoscopic surgery (SITS) is being applied to various thoracic diseases because it produces a smaller surgical scar, and is associated with less pain and loss of sensation compared to the traditional 3-port video-assisted thoracoscopic surgery (VATS). In our previous study, we showed that SITS can be used as a first-line surgical method to treat primary spontaneous pneumothorax. Therefore in this study, we looked into whether SITS can be safely and conveniently applied to other various thoracic diseases. Methods: The subjects for this study those patients who underwent SITS at this hospital for thoracic diseases, who were admitted to this hospital between December 2013 and February 2015. Results: In this study, SITS was attempted in 50 patients with various thoracic diseases. In 46 cases, SITS was successfully performed. However, in the remaining 4 cases were converted to 2-port or 3-port VATS (8%, 4/50). The reasons for conversion to VATS was due to difficulty in approaching the lesion (n= 3) and severe pleural adhesion (n= 1). Conclusion: We found that SITS is a relatively easy and safe procedure that can be applied to various thoracic diseases. However, the operation may be difficult to perform depending on the location of the lesions or the extent of pleural adhesions. Therefore we recommend SITS in conditions where the lesion is mainly in the upper lobe, such as spontaneous pneumothorax, and in patients with minimal level of pleural adhesions.

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Single-port thoracoscopic surgery can be a first-line approach for elective thoracoscopic surgery

Abstract: Elective thoracoscopic surgery performed through a single-port wound is feasible. Single-incisional thoracoscopic surgery can be safely applied as a first-line approach in most cases of elective thoracoscopic procedures.

Cited by 7 publications

References 10 publications

Clinical application of single incision thoracoscopic surgery: early experience of 264 cases

Clinical application of single incision thoracoscopic surgery: early experience of 264 cases

Treatment of Bilateral Empyema Thoracis Using Unilateral Single-Port Thoracoscopic Approach

A Study into the Potential for Safe Application of Single-Incision Thoracoscopic Surgery in Various Thoracic Diseases

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