A Matched Comparison Study of Uniportal Versus Triportal Thoracoscopic Lobectomy and Sublobectomy for Early-stage Nonsmall Cell Lung Cancer

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2015 Oct 21

PMID 26481738

Citations 31

Authors

Ju-Wei Mu

Shu-Geng Gao

Qi Xue

Jun Zhao

Ning Li

Kun Yang

Kai Su

Zhu-Yang Yuan

Jie He

Affiliations

Soon will be listed here.

Abstract

Background: Both uniportal and triportal thoracoscopic lobectomy and sublobectomy are feasible for early-stage non-small cell lung cancer (NSCLC). The aim of this study was to compare the perioperative outcomes of uniportal and triportal thoracoscopic lobectomy and sublobectomy for early-stage NSCLC.

Methods: A total of 405 patients with lung lesions underwent thoracoscopic lobectomy or sublobectomy through a uniportal or triportal procedure in approximately 7-month period (From November 2014 to May 2015). A propensity-matched analysis, incorporating preoperative variables, was used to compare the short-term outcomes of patients who received uniportal or triportal thoracoscopic lobectomy and sublobectomy.

Results: Fifty-eight patients underwent uniportal and 347 patients underwent triportal pulmonary resection. The conversion rate for uniportal and triportal procedure was 3.4% (2/58) and 2.3% (8/347), respectively. The complication rate for uniportal and triportal procedure was 10.3% and 9.5%, respectively. There was no perioperative death in either group. Most patients had early-stage NSCLC in both groups (uniportal: 45/47, 96%; triportal: 313/343, 91%). Propensity score-matching analysis demonstrated no significant differences in operation time, intraoperative blood loss, numbers of dissected lymph nodes, number of stations of lymph node dissected, duration of chest tube, and complication rate between uniportal and triportal group for early-stage NSCLC. However, the duration of postoperative hospitalization was longer in the uniportal group (6.83 ± 4.17 vs. 5.42 ± 1.86 d, P = 0.036) compared with the triportal group.

Conclusions: Uniportal thoracoscopic lobectomy and sublobectomy is safe and feasible, with comparable short-term outcomes with triportal thoracoscopic pulmonary resection. Uniportal lobectomy and sublobectomy lead to similar cure rate as triportal lobectomy and sublobectomy for early NSCLC.

Citing Articles

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Outcomes of Uniportal Video-Assisted Thoracoscopic Surgery in the Management of Lobectomy and Segmentectomy for Lung Cancer: A Systematic Review and Meta-Analysis of Propensity Score-Matched Cohorts.

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References

Rocco G, Martucci N, La Manna C, Jones D, De Luca G, La Rocca A . Ten-year experience on 644 patients undergoing single-port (uniportal) video-assisted thoracoscopic surgery. Ann Thorac Surg. 2013; 96(2):434-8. DOI: 10.1016/j.athoracsur.2013.04.044. View

Zhong C, Fang W, Mao T, Yao F, Chen W, Hu D . Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy for small-sized stage IA lung cancer. Ann Thorac Surg. 2012; 94(2):362-7. DOI: 10.1016/j.athoracsur.2012.04.047. View

Gonzalez D, de la Torre M, Paradela M, Fernandez R, Delgado M, Garcia J . Video-assisted thoracic surgery lobectomy: 3-year initial experience with 200 cases. Eur J Cardiothorac Surg. 2011; 40(1):e21-8. DOI: 10.1016/j.ejcts.2011.02.051. View

Gonzalez-Rivas D, Delgado M, Fieira E, Fernandez R . Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg. 2014; 3(2):E2. PMC: 4052566. DOI: 10.3978/j.issn.2225-319X.2014.03.13. View

Ng C . Uniportal VATS in Asia. J Thorac Dis. 2013; 5 Suppl 3:S221-5. PMC: 3771594. DOI: 10.3978/j.issn.2072-1439.2013.07.06. View

Chu X, Xue Z, Zhang L, Hou X, Ma K . [Primary report of lobectomy with single utility port complete video-assisted thoracoscopic surgery]. Zhongguo Fei Ai Za Zhi. 2010; 13(1):19-21. PMC: 6000672. DOI: 10.3779/j.issn.1009-3419.2010.01.03. View

Xu C, Ma H, Ni B, He J, Li C, Ding C . [Analysis of single-operation-hole thoracoscopic lobectomy in 113 clinical cases]. Zhongguo Fei Ai Za Zhi. 2014; 17(5):424-7. PMC: 6000449. DOI: 10.3779/j.issn.1009-3419.2014.05.11. View

Nakamura K, Saji H, Nakajima R, Okada M, Asamura H, Shibata T . A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol. 2009; 40(3):271-4. DOI: 10.1093/jjco/hyp156. View

Chen W, Zheng R, Zeng H, Zhang S, He J . Annual report on status of cancer in China, 2011. Chin J Cancer Res. 2015; 27(1):2-12. PMC: 4329176. DOI: 10.3978/j.issn.1000-9604.2015.01.06. View

10.

Nwogu C, DCunha J, Pang H, Gu L, Wang X, Richards W . VATS lobectomy has better perioperative outcomes than open lobectomy: CALGB 31001, an ancillary analysis of CALGB 140202 (Alliance). Ann Thorac Surg. 2014; 99(2):399-405. PMC: 5616174. DOI: 10.1016/j.athoracsur.2014.09.018. View

11.

Higuchi M, Yaginuma H, Yonechi A, Kanno R, Ohishi A, Suzuki H . Long-term outcomes after video-assisted thoracic surgery (VATS) lobectomy versus lobectomy via open thoracotomy for clinical stage IA non-small cell lung cancer. J Cardiothorac Surg. 2014; 9:88. PMC: 4058716. DOI: 10.1186/1749-8090-9-88. View

12.

Wang B, Liu C, Hsu P, Shih C, Liu C . Single-incision versus multiple-incision thoracoscopic lobectomy and segmentectomy: a propensity-matched analysis. Ann Surg. 2014; 261(4):793-9. DOI: 10.1097/SLA.0000000000000712. View

13.

Liu Y, Huang C, Liu H, Chen Y, Li S . Sublobectomy versus lobectomy for stage IA (T1a) non-small-cell lung cancer: a meta-analysis study. World J Surg Oncol. 2014; 12:138. PMC: 4029973. DOI: 10.1186/1477-7819-12-138. View

14.

Zhang Y, Sun Y, Wang R, Ye T, Zhang Y, Chen H . Meta-analysis of lobectomy, segmentectomy, and wedge resection for stage I non-small cell lung cancer. J Surg Oncol. 2014; 111(3):334-40. DOI: 10.1002/jso.23800. View

15.

Wang B, Tu C, Liu C, Shih C, Liu C . Single-incision thoracoscopic lobectomy and segmentectomy with radical lymph node dissection. Ann Thorac Surg. 2013; 96(3):977-82. DOI: 10.1016/j.athoracsur.2013.05.002. View

16.

Gonzalez-Rivas D, Delgado M, Fieira E, Mendez L . Single-port video-assisted thoracoscopic lobectomy with pulmonary artery reconstruction. Interact Cardiovasc Thorac Surg. 2013; 17(5):889-91. PMC: 3805214. DOI: 10.1093/icvts/ivt340. View

17.

Carr S, Schuchert M, Pennathur A, Wilson D, Siegfried J, Luketich J . Impact of tumor size on outcomes after anatomic lung resection for stage 1A non-small cell lung cancer based on the current staging system. J Thorac Cardiovasc Surg. 2011; 143(2):390-7. DOI: 10.1016/j.jtcvs.2011.10.023. View

18.

Mu J, Chen G, Sun K, Wang D, Zhang B, Li N . Application of video-assisted thoracic surgery in the standard operation for thoracic tumors. Cancer Biol Med. 2013; 10(1):28-35. PMC: 3643687. DOI: 10.7497/j.issn.2095-3941.2013.01.005. View

19.

Rocco G, Khalil M, Jutley R . Uniportal video-assisted thoracoscopic surgery wedge lung biopsy in the diagnosis of interstitial lung diseases. J Thorac Cardiovasc Surg. 2005; 129(4):947-8. DOI: 10.1016/j.jtcvs.2004.08.027. View

20.

Jemal A, Bray F, Center M, Ferlay J, Ward E, Forman D . Global cancer statistics. CA Cancer J Clin. 2011; 61(2):69-90. DOI: 10.3322/caac.20107. View