Systematic mediastinal lymph node dissection outcomes and conversion rates of uniportal video‐assisted thoracoscopic lobectomy for lung cancer

Abstract

Background: To evaluate the systematic mediastinal lymph node (LN) dissection outcomes and conversion rates of uniportal video-assisted thoracoscopic surgery (UVATS). Methods: Patients with non-small-cell lung cancer who underwent video-assisted thoracoscopic surgery (VATS) and systematic mediastinal LN dissection between January 2015 and January 2017 were retrospectively reviewed. We categorized the patients into two groups according to the different surgical approaches. Patients' clinical data were collected and compared. The index of estimated benefit from LN dissection was used to evaluate the therapeutic value of LN dissection for each station. Results: A total of 453 patients underwent VATS, including 197 patients in the UVATS group and 256 patients in the triportal VATS (TVATS) group. There were no significant differences in the 1-, 2-and 3-year survival rates of these two groups (P > 0.05). There were no statistically significant differences in the operative time, numbers and stations of LNs, numbers and stations of N2 LNs, conversion rate or postoperative complications. The UVATS group had less intraoperative blood loss, a shorter duration of hospital stay, less chest tube drainage and a shorter duration of chest tube drainage than the TVATS group (P < 0.05). The conversion rates in the UVATS and TVATS groups were 5.1% and 4.3%, respectively, and the difference was not significant. The same degree of LN sampling was achieved in both groups. Conclusion: UVATS permits the same degree of LN sampling as TVATS without a difference in the conversion rate.

Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer

“…Till now, few reports compared surgical outcomes after triportal-VATS and U-VATS (2,4,19): they found out that U-VATS was associated with significantly less intraoperative blood loss, less chest tube drainage volume and duration, and less post-operative pain and hospital stay. The same results were also reached by Wu and coworkers (20), recently. They also proved that, on a total of 443 patients who underwent VATS (197 U-VATS and 256 triportal-VATS), there were no significant differences in 1-,2-, and 3-year survival rates between the two groups of VATS and that the number of lymphnodes removed per station was similar and consistent with required standards in the two groups (10).…”

Novel systemic inflammation response index to predict prognosis after thoracoscopic lung cancer surgery: a propensity score‐matching study

“…Lung cancer is the leading cause of malignancy‐related deaths worldwide, and non‐small‐cell lung cancer (NSCLC) accounts for approximately 85% of all these cases . Despite advances in surgical techniques and combined treatment modalities, the clinical prognosis of NSCLC still remains frustrating, with a poor survival rate around 20–40% . A better understanding of putative indicators will play a vital role in assisting thoracic surgeons to identify which patients are considered at a higher probability of unfavourable prognosis and further settling an appropriate therapeutic plan in advance.…”

Comparison of survival results of patients with T0 and T1-2-3 in pathological T staging in patients with non-small cell lung cancer who underwent surgery after neoadjuvant treatment

“…The standard surgical procedures to be performed in patients with stage II are lobectomy, bilobectomy or pneumonectomy, and mediastinal lymph node dissection [13]. In our series, pneumonectomy was performed in 27 (13.8%) patients and bilobectomy was performed in 21 (10.8%) patients.…”