Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Peripheral Non-small Cell Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GAOYong-shan ¹ , XUEZhan-xia ² , DONGYue-hua ¹ , WANGDa-wei ¹ , YANGYan-jun ¹ , WEIYu-lei ¹ , JIANGWei-hua ¹ ,  ZHANGZhen-ming ¹

1. Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000 Hebei, P. R. China;
2. Department of Pharmacology, Hebei North University, Zhangjiakou 075000 Hebei, P. R. China;

Corresponding author：

ZHANGZhen-ming, Email: m18231372816@163.com

Keywords：

Lobectomy; Lung cancer; Single utility port; Video-assisted thoracic surgery (VATS)

DOI：

10.7507/1007-4848.20160266

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate clinical outcomes of single utility port video-assisted thoracoscopic surgery (VATS) lobectomy for patients with early-stage peripheral non-small cell lung cancer. Methods We retrospectively analyzed the clinical data of 46 consecutive patients with early-stage peripheral non-small cell lung cancer who underwent single utility port complete VATS lobectomy in the First Affiliated Hospital of Hebei north University from December 2012 through November 2014. There were 39 male patients and 7 female patients with their age of 42-76 (60.26±4.38) years (VATS group). There were 58 patients with early-stage peripheral non-small cell lung cancer who underwent lobectomy via traditional thoracotomy including 47 male and 11 female patients with their age of 44-73 (61.42±3.67) years for the same period (conventional thoracotomy group). Clinical outcomes were compared between the two groups. Results All the operations were successful. There was no conversions during single utility port VATS lobectomy, and no periopera-tive death in both groups. The VATS group had significantly less blood loss (126.10±48.56 ml vs. 260.84±69.70 ml), and amount of thoracic drainage (230.52±50.22 ml vs. 380.16±96.24 ml, P<0.05). Hospital stay was significantly shorter in the VATS group than the conventional thoracotomy group (6.42±1.40 days vs. 9.64±2.08 days, P<0.05). However, there was no significant difference between the VATS group and the conventional thoracotomy group with regard to the opera-ting time (146.25±19.68 minutes vs. 139.26±25.39 minutes), number of lymph nodes procured (13.56±2.31 vs. 14.12±3.06), and postoperative complications (13.0% vs. 19.0%, P>0.05). Conclusion Single utility port VATS lobectomy for patients with early-stage peripheral non-small cell lung cancer is technically feasible, with less blood loss and shorter hospital stays for achieving acceptable standards of lymph node dissection. It is a promising surgical procedures for patients with early-stage peripheral non-small cell lung cancer.

Citation： GAOYong-shan, XUEZhan-xia, DONGYue-hua, WANGDa-wei, YANGYan-jun, WEIYu-lei, JIANGWei-hua, ZHANGZhen-ming. Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Peripheral Non-small Cell Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(12): 1132-1135. doi: 10.7507/1007-4848.20160266 Copy

1.	初向阳，薛志强，刘毅，等.单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床研究.中国胸心血管外科临床杂志, 2012, 19(2): 113-115.
2.	Ilonen IK1, Räsänen JV, Knuuttila A, et al. Anatomic thoracoscopic lung resection for non-small cell lung cancer in stage I is associated with less morbidity and shorter hospitalization than thoracotomy. Acta Oncol, 2011, 50(7): 1126-1132.
3.	Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-77.
4.	刘伦旭, 车国卫, 蒲强, 等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24(3): 156-158.
5.	蔡海波, 李迎新, 张士法, 等. 完全电视胸腔镜肺叶切除术治疗早期肺癌的近期疗效评价. 中国胸心血管外科临床杂志, 2014, 21(2): 224-227.
6.	李畅, 马海涛, 何靖康, 等.单操作孔肺叶切除术治疗周围型肺癌的临床研究. 中国肺癌杂志, 2013, 16(9): 487-491.
7.	郑轶峰, 姜建青, 杨列, 等. 全胸腔镜肺叶切除术60例临床分析. 中国胸心血管外科临床杂志, 2013, 20(2): 172-175.
8.	McKenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-426.
9.	West D, Rashid S, Dunning J. Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobec-tomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg, 2007, 6(1): 110-116.
10.	蒋伟, 奚俊杰, 王群, 等. 全胸腔镜肺癌根治术淋巴结清扫的探讨. 中国微创外科杂志, 2012, 12(11): 969-972.
11.	Kim HK, Choi Ys, Kim J, et al. Outcomes of unexpected pathologic N1 and N2 disease after video-assisted thoracic surgery lobectomy for clinical stage I non-small cell lung cancer. J Thorac Cardiovasc Surg, 2010, 140(6): 1288-1293.
12.	Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
13.	黄佳, 赵晓菁, 林皓, 等. 单向四孔法全胸腔镜肺叶切除术治疗非小细胞肺癌的临床研究. 中国胸心血管外科临床杂志, 2012, 19(2): 125-129.
14.	车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视胸腔镜手术治疗肺部疾病158例临床分析. 中国胸心血管外科临床杂志, 2012, 19(2): 116-119.
15.	车国卫, 刘伦旭. 单孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
16.	初向阳, 薛志强, 张连斌, 等. 单操作孔胸腔镜肺叶切除术的初步报道. 中国肺癌杂志, 2010, 13(1): 19-21.
17.	Jutley RS, Khalil Mw, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg, 2005, 28(1): 43-46.
18.	王光宇, 初向阳, 李国, 等. 单操作孔电视胸腔镜与开胸肺癌根治术对早期肺癌淋巴结清扫及疗效的对比研究. 中国医药, 2014, 1(9): 37-40.
19.	王光宇, 初向阳, 李国, 等. 单操作孔电视胸腔镜肺叶切除术的学习曲线研究. 中国医药, 2014, 9(5): 642-644.
20.	蒲强, 车国卫, 刘伦旭, 等. 单向式全胸腔镜肺癌切除术的学习曲线分析. 中华外科杂志, 2010, 48(15): 1161-1165.

1. 初向阳，薛志强，刘毅，等.单操作孔电视胸腔镜肺叶切除术治疗早期肺癌的临床研究.中国胸心血管外科临床杂志, 2012, 19(2): 113-115.
2. Ilonen IK1, Räsänen JV, Knuuttila A, et al. Anatomic thoracoscopic lung resection for non-small cell lung cancer in stage I is associated with less morbidity and shorter hospitalization than thoracotomy. Acta Oncol, 2011, 50(7): 1126-1132.
3. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-77.
4. 刘伦旭, 车国卫, 蒲强, 等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24(3): 156-158.
5. 蔡海波, 李迎新, 张士法, 等. 完全电视胸腔镜肺叶切除术治疗早期肺癌的近期疗效评价. 中国胸心血管外科临床杂志, 2014, 21(2): 224-227.
6. 李畅, 马海涛, 何靖康, 等.单操作孔肺叶切除术治疗周围型肺癌的临床研究. 中国肺癌杂志, 2013, 16(9): 487-491.
7. 郑轶峰, 姜建青, 杨列, 等. 全胸腔镜肺叶切除术60例临床分析. 中国胸心血管外科临床杂志, 2013, 20(2): 172-175.
8. McKenna RJ, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg, 2006, 81(2): 421-426.
9. West D, Rashid S, Dunning J. Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobec-tomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg, 2007, 6(1): 110-116.
10. 蒋伟, 奚俊杰, 王群, 等. 全胸腔镜肺癌根治术淋巴结清扫的探讨. 中国微创外科杂志, 2012, 12(11): 969-972.
11. Kim HK, Choi Ys, Kim J, et al. Outcomes of unexpected pathologic N1 and N2 disease after video-assisted thoracic surgery lobectomy for clinical stage I non-small cell lung cancer. J Thorac Cardiovasc Surg, 2010, 140(6): 1288-1293.
12. Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
13. 黄佳, 赵晓菁, 林皓, 等. 单向四孔法全胸腔镜肺叶切除术治疗非小细胞肺癌的临床研究. 中国胸心血管外科临床杂志, 2012, 19(2): 125-129.
14. 车国卫, 梅龙勇, 梅建东, 等. 单操作孔电视胸腔镜手术治疗肺部疾病158例临床分析. 中国胸心血管外科临床杂志, 2012, 19(2): 116-119.
15. 车国卫, 刘伦旭. 单孔电视胸腔镜手术临床应用的现状与进展. 中国胸心血管外科临床杂志, 2012, 19(2): 181-184.
16. 初向阳, 薛志强, 张连斌, 等. 单操作孔胸腔镜肺叶切除术的初步报道. 中国肺癌杂志, 2010, 13(1): 19-21.
17. Jutley RS, Khalil Mw, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg, 2005, 28(1): 43-46.
18. 王光宇, 初向阳, 李国, 等. 单操作孔电视胸腔镜与开胸肺癌根治术对早期肺癌淋巴结清扫及疗效的对比研究. 中国医药, 2014, 1(9): 37-40.
19. 王光宇, 初向阳, 李国, 等. 单操作孔电视胸腔镜肺叶切除术的学习曲线研究. 中国医药, 2014, 9(5): 642-644.
20. 蒲强, 车国卫, 刘伦旭, 等. 单向式全胸腔镜肺癌切除术的学习曲线分析. 中华外科杂志, 2010, 48(15): 1161-1165.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Single Utility Port Video-assisted Thoracoscopic Surgery Lobectomy for Patients with Early-stage Peripheral Non-small Cell Lung Cancer

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