Uniport versus Single Utility Port Video-assisted Thoracic Surgery for Benign Thoracic Diseases: A Randomized Controlled Trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIONGJian , YUWei-min , WANGDong-dong , LIZhi-cheng , WANGChang-tao ,  XUYong-dong

Department of Thoracic Surgery, Shanghai Pudong Hospital, Fudan University, Shanghai 201399, P. R. China;

Corresponding author：

XUYong-dong, Email: xyd927927@163.com

Keywords：

Uniport; Single utility port; Video-assisted thoracic surgery; Benign thoracic disease

DOI：

10.7507/1007-4848.20160208

Video：

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Objective To discuss the advantage and disadvantage of uniport video-assisted thoracic surgery (VATS) versus single utility port VATS in the surgical treatment of benign thoracic diseases. Methods From January 2012 to December 2014, 125 patients with benign thoracic diseases who underwent VATS by the same performer were divided randomly into two groups including a uniport VATS group or a single utility port VATS group. There were 41 males and 24 females with a mean age of 47.5±16.6 years in the uniport VATS group. There were 39 males and 21 females with a mean age of 45.1±15.7 years in the single utility port VATS group. Then the patients were followed up. The perioperative data and follow-up results were compared between two groups. Results The total 125 patients of operations were performed successfully according the established plan, without increasing incisions or transferring to thoracotomy. There were no statistical differences between two groups in operative time (48.9±11.3 min vs. 47.1±11.0 min), intraoperative bleeding volume (26.9±15.4 ml vs. 23.8±13.2 ml), postoperative 24 h chest tube drainage volume (81.5±36.9 ml vs. 77.3±31.2 ml), postoperative chest tube drainage time (2.8±2.0 d vs. 3.4±2.2 d), the pain score on the 3rd postoperative day (2.6±1.2 points vs. 2.6±1.3 points), average in-hospital stay (4.9±2.1 d vs. 5.1±2.2 d) or postoperative complications (P > 0.05). The patients were followed up for 3-24 months. All patients achieved satisfactory results with no recurrence. Conclusions Compared with single utility port VATS, uniport VATS does not prolong operation time or consume more materials, and has advantages of minimally invasion and higher acceptance. It is a safe and feasible approach in surgical treatment of benign thoracic diseases and worthy of popularization and application.

Citation： XIONGJian, YUWei-min, WANGDong-dong, LIZhi-cheng, WANGChang-tao, XUYong-dong. Uniport versus Single Utility Port Video-assisted Thoracic Surgery for Benign Thoracic Diseases: A Randomized Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(9): 869-872. doi: 10.7507/1007-4848.20160208 Copy

1.	Sihoe AD, Yim AP, Chief editor. Video-assisted pulmonary resections. In:Patterson FG, Cooper JD, Deslauriers J. eds. Thoracic Surgery (3rd Edition). Philadelphia:Elsevier, 2008. 970-88.
2.	Sihoe AD, Yim AP, Chief editor. VATS as a diagnostic tool. In:Shields TW, LoCicero J, Reed CE, et al. eds. General Thoracic Surgery (7th Edition). Philadelphia:Lippincott Williams & Wilkins, 2009. 313-32.
3.	Li WW, Lee TW, Lam SS, et al. Quality of life following lung cancer resection:video-assisted thoracic surgery vs thoracotomy. Chest, 2002, 122(2):584-589.
4.	Sihoe AD, Chief editor. The Evolution of VATS Lobectomy. In:Cardoso P. eds. Topics in Thoracic Surgery. Rijeka:Intech, 2011. 181-210.
5.	Landreneau RJ, Mack MJ, Hazelrigg SR, et, al. Video-assisted thoracic surgery:basic technical concepts and intercostal approach strategies. Ann Thorac Surg, 1992, 54(4):800-807.
6.	LoCicero J 2nd. Minimally invasive thoracic surgery, video-assisted thoracic surgery and thoracoscopy. Chest, 1992, 102(2):330-331.
7.	Wang GS, Wang J, Rao ZP, et al. Uniportal complete video-assisted thoracoscopic surgery lobectomy with partial pulmonary arterioplasty for lung cancer with calcified lymph node. J Thorac Dis, 2015, 7(12):2366-2370.
8.	Lin Z, Xu S, Wang Q. Uniportal video-assisted thoracoscopic surgery right upper lobectomy with systematic lymphadenectomy in a semiprone position. J Thorac Dis, 2014, 6(12):1840-1842.
9.	Tam JK, Lim KS. Total muscle-sparing uniportal video-assisted thoracoscopic surgery lobectomy. Ann Thorac Surg, 2013, 96(6):1982-1986.
10.	Wang GS, Wang J, Rao ZP, et al. Uniportal complete video-assisted thoracoscopic surgery lobectomy with partial pulmonary arterioplasty for lung cancer with calcified lymph node. J Thorac Dis, 2015, 7(12):2366-2370.
11.	Sihoe AD. The evolution of minimally invasive thoracic surgery:implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis, 2014, 6(Suppl 6):S604-S617.
12.	Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg, 2004, 77(2):726-728.
13.	Rocco G, Martucci N, La Manna C, et al. Ten-year experience on 644 patients undergoing single-port (uniportal) video-assisted thoracoscopic surgery. Ann Thorac Surg, 2013, 96(2):434-438.
14.	Gonzalez-Rivas D, de la Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg, 2011, 13(5):539-541.
15.	Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis, 2014, 6(6):641-648.
16.	Gonzalez-Rivas D, Delgado M, Fieira E, et al.Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg, 2014, 3(2):E2.
17.	Gonzalez-Rivas D, Paradela M, Fernandez R, et al.Uniportal video-assisted thoracoscopic lobectomy:two years of experience. Ann Thorac Surg, 2013, 95(2):426-432.
18.	Gonzalez-Rivas D, Delgado M, Fieira E, et al. Uniportal video-assisted thoracoscopic pneumonectomy. J Thorac Dis, 2013, 5(Suppl 3):S246-S252.
19.	Gonzalez-Rivas D. Recent advances in uniportal video-assisted thoracoscopic surgery. Chin J Cancer Res, 2015, 27(1):90-93.
20.	Jimenez MF. Uniportal versus standard video-assisted thoracoscopic surgery for lung lobectomy:changing the standards requires scientific evidence. Eur J Cardiothorac Surg, 2015, 47(5):916.

1. Sihoe AD, Yim AP, Chief editor. Video-assisted pulmonary resections. In:Patterson FG, Cooper JD, Deslauriers J. eds. Thoracic Surgery (3rd Edition). Philadelphia:Elsevier, 2008. 970-88.
2. Sihoe AD, Yim AP, Chief editor. VATS as a diagnostic tool. In:Shields TW, LoCicero J, Reed CE, et al. eds. General Thoracic Surgery (7th Edition). Philadelphia:Lippincott Williams & Wilkins, 2009. 313-32.
3. Li WW, Lee TW, Lam SS, et al. Quality of life following lung cancer resection:video-assisted thoracic surgery vs thoracotomy. Chest, 2002, 122(2):584-589.
4. Sihoe AD, Chief editor. The Evolution of VATS Lobectomy. In:Cardoso P. eds. Topics in Thoracic Surgery. Rijeka:Intech, 2011. 181-210.
5. Landreneau RJ, Mack MJ, Hazelrigg SR, et, al. Video-assisted thoracic surgery:basic technical concepts and intercostal approach strategies. Ann Thorac Surg, 1992, 54(4):800-807.
6. LoCicero J 2nd. Minimally invasive thoracic surgery, video-assisted thoracic surgery and thoracoscopy. Chest, 1992, 102(2):330-331.
7. Wang GS, Wang J, Rao ZP, et al. Uniportal complete video-assisted thoracoscopic surgery lobectomy with partial pulmonary arterioplasty for lung cancer with calcified lymph node. J Thorac Dis, 2015, 7(12):2366-2370.
8. Lin Z, Xu S, Wang Q. Uniportal video-assisted thoracoscopic surgery right upper lobectomy with systematic lymphadenectomy in a semiprone position. J Thorac Dis, 2014, 6(12):1840-1842.
9. Tam JK, Lim KS. Total muscle-sparing uniportal video-assisted thoracoscopic surgery lobectomy. Ann Thorac Surg, 2013, 96(6):1982-1986.
10. Wang GS, Wang J, Rao ZP, et al. Uniportal complete video-assisted thoracoscopic surgery lobectomy with partial pulmonary arterioplasty for lung cancer with calcified lymph node. J Thorac Dis, 2015, 7(12):2366-2370.
11. Sihoe AD. The evolution of minimally invasive thoracic surgery:implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis, 2014, 6(Suppl 6):S604-S617.
12. Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg, 2004, 77(2):726-728.
13. Rocco G, Martucci N, La Manna C, et al. Ten-year experience on 644 patients undergoing single-port (uniportal) video-assisted thoracoscopic surgery. Ann Thorac Surg, 2013, 96(2):434-438.
14. Gonzalez-Rivas D, de la Torre M, Fernandez R, et al. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg, 2011, 13(5):539-541.
15. Gonzalez-Rivas D, Fieira E, Delgado M, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis, 2014, 6(6):641-648.
16. Gonzalez-Rivas D, Delgado M, Fieira E, et al.Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer. Ann Cardiothorac Surg, 2014, 3(2):E2.
17. Gonzalez-Rivas D, Paradela M, Fernandez R, et al.Uniportal video-assisted thoracoscopic lobectomy:two years of experience. Ann Thorac Surg, 2013, 95(2):426-432.
18. Gonzalez-Rivas D, Delgado M, Fieira E, et al. Uniportal video-assisted thoracoscopic pneumonectomy. J Thorac Dis, 2013, 5(Suppl 3):S246-S252.
19. Gonzalez-Rivas D. Recent advances in uniportal video-assisted thoracoscopic surgery. Chin J Cancer Res, 2015, 27(1):90-93.
20. Jimenez MF. Uniportal versus standard video-assisted thoracoscopic surgery for lung lobectomy:changing the standards requires scientific evidence. Eur J Cardiothorac Surg, 2015, 47(5):916.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Uniport versus Single Utility Port Video-assisted Thoracic Surgery for Benign Thoracic Diseases: A Randomized Controlled Trial

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