Uniportal and three-portal video-assisted thoracic surgery pulmonary lobectomy for early-stage lung cancer (UNIT trial): study protocol of a single-center randomized trial

Abstract

Background Video-assisted thoracoscopic surgery (VATS) lobectomy is currently the recommended approach for treating early-stage non-small cell lung cancer (NSCLC). Different VATS approaches have been proposed so far, and the actual advantages of one technique over the other are still under debate. The aim of our study is to compare postoperative pain and analgesic drug consumption in uniportal VATS and triportal VATS for pulmonary lobectomy in early-stage lung cancer patients. Methods This study is a single-center, prospective, two-arm, parallel-group, randomized controlled trial. It is designed to compare uniportal video-assisted thoracic surgery (u-VATS) and three-port video-assisted thoracic surgery (t-VATS) in terms of postoperative pain. The trial will enroll 120 patients with a 1:1 randomization. The primary outcome is the assessment of analgesic drug consumption. Secondary outcomes are postoperative pain measurement, evaluation of postoperative pulmonary function, and metabolic recovery after pulmonary lobectomy. Discussion The choice of which VATS approach to adopt for treating patients undergoing pulmonary resection mostly depends on the surgeon’s preferences; therefore, it is hard to prove whether one VATS technique is superior to the other. Moreover, postoperative analgesic protocols vary consistently among different centers. To date, only a few studies have evaluated the effects of the most popular VATS techniques. There is no evidence about the difference between multiport VATS and u-VATS in terms of postoperative pain. We hope that the results of our trial will provide valuable information on the outcomes of these different surgical approaches. Trial registration ClinicalTrials.gov NCT03240250. Registered on 07 August 2017; retrospectively registered.

Management of middle lobe veins during single-portal video-assisted thoracoscopic surgery lobectomy via the fifth intercostal approach (case series): why the subcarinal triangular right base angle is helpful

“…Moreover, pain score was relatively lower in the uniportal VATS group. In addition, an ongoing prospective, randomized controlled study performed by Mendogni et al ( 4 ) may provide more information about the surgical outcomes of different surgical approaches. Some studies have evaluated the learning curve of uniportal lobectomy or segmentectomy ( 5 - 8 ).…”

Pulmonary Lobectomy for Early-Stage Lung Cancer with Uniportal versus Three-Portal Video-Assisted Thoracic Surgery: Results from a Single-Centre Randomized Clinical Trial

“…Postoperative complications were categorized as follows: surgical site infection; prolonged air leaks (>7 days); pulmonary complications (fever and/or high inflammatory markers associated with pulmonary consolidation at chest X-ray requiring antimicrobial therapy, pulmonary atelectasis requiring bronchial aspiration, lung hernia, pneumothorax requiring chest drain placement); cardiac complications; and other complications. In the operating theatre, right before surgery, patients were randomly assigned to either the T-VATS Group, and therefore underwent three-portal VATS lobectomy and lymphadenectomy, or the U-VATS Group, and therefore underwent uni-portal VATS lobectomy and lymphadenectomy [25] (Figure 1). Surgeons in charge of performing the planned surgery had already completed their learning curve for both techniques.…”

Efficacy of multi-groove silicone drains in single-port video-assisted thoracoscopic lung cancer surgery and their effect on C-reactive protein: a single-center experience

“…All of the instruments and camera were inserted through this incision. At the end of lobectomy and lymphadenectomy, a multigroove silicone drain was inserted through the incision (14).…”