Uniportal <i>versus</i> multiportal video-assisted thoracoscopic lobectomy under the concept of enhanced recovery after surgery: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIANG Run ,  ZHU Jiang , LI Qiang , XIE Tianpeng , YANG Xiaojun ,  HE Jintao

Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P.R.China;

Corresponding author：

ZHU Jiang, Email: 13008148289@163.com; HE Jintao, Email: HJTabc3@163.com

Keywords：

Enhanced recovery after surgery; lung carcinoma; lobectomy; uniportal video-assisted thoracoscopy

DOI：

10.7507/1007-4848.201705049

Video：

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Objective To compare the effect of uniportal and multiportal thoracoscopic lobectomy, and to explore the advantages and applications of uniportal thoracoscopic lobectomy in enhanced recovery after surgery. Methods Totally 169 patients with video-assisted thoracoscopic lobectomy in Department of Thoracic Surgery of Sichuan Cancer Hospital from January to December 2016 were enrolled. There were 99 males and 70 females with age of 60.83±7.24 years. Patients were divided into two groups: a uniportal group (78 patients) and a multiportal group (91 patients) . Patients’ clinical and pathological materials were collected. Postoperative pain, complications and hospital stay, etc of the two groups were compared. Results All patients were successfully discharged without serious postoperative complication or death. Patients in the multiportal group had smaller surgical incisions than that in the uniportal group (3.12±0.73 cm vs. 6.38±1.50 cm, P=0.016). Pain scores at postoperative 24 and 48 hours of the uniportal group were less than those of multiportal group (4.18±1.67 vs. 6.54±1.83, 3.05±1.47 vs. 4.68±1.64, P<0.05). Operation data, postoperative complications and hospital stay were similar in both groups. Conclusion Uniportal video-assisted thoracoscopic lobectomy makes smaller incisions and can further reduce postoperative pain and dosage of morphine. The operation is safe and worthy of wide application in enhanced recoveryafter surgery.

Citation： XIANG Run, ZHU Jiang, LI Qiang, XIE Tianpeng, YANG Xiaojun, HE Jintao. Uniportal versus multiportal video-assisted thoracoscopic lobectomy under the concept of enhanced recovery after surgery: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(4): 284-288. doi: 10.7507/1007-4848.201705049 Copy

1.	刘成武, 刘伦旭. 肺癌微创外科治疗进展. 中华胸部外科电子杂志, 2016, 3(2): 65-69.
2.	吴一旻, 柴莹. 单孔胸腔镜在肺癌外科中的应用进展. 国际外科学杂志, 2016, 43(5): 357-360.
3.	刘成武, 刘伦旭. 单孔胸腔镜: 微创肺癌切除的再次升华. 中国肺癌杂志, 2014, 17(7): 527-530.
4.	Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis, 2014, 6(1): 14-21.
5.	Sihoe AD. Uniportal video-assisted thoracic (VATS) lobectomy. Ann Cardiothorac Surg, 2016, 5(2): 133-144.
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13.	Andrews WG, Paul S. Techniques of video-assisted thoracoscopic surgery lobectomy and critical review of published data. Future Oncol, 2016, 12(23s): 31-33.
14.	Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
15.	Gonzalez-Rivas D, Fieira E, Mendez L, et al. Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. Eur J Cardiothorac Surg, 2012, 42(6): e169-e171.
16.	邓豫, 郝志鹏, 付向宁. “精准医疗”理念下单孔VATS肺癌根治术的发展现状、应用细节和展望. 中国肺癌杂志, 2016, 19(6): 371-376.
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18.	尹逊亮, 周勇安, 赵宁, 等. 单孔及多孔法胸腔镜手术治疗周围型非小细胞肺癌临床疗效的病例对照研究. 中国胸心血管外科临床杂志, 2016, 23(11): 1044-1049.
19.	朱启航, 肖海平, 何哲, 等. 3 种电视胸腔镜下手术治疗非小细胞肺癌早期创伤反应的比较. 实用医学杂志, 2016, 32(2): 231-235.
20.	Lin Y, Zheng W, Zhu Y, et al. Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study. J Thorac Dis, 2016, 8(6): 1290-1296.
21.	马俊杰,高德军. 不同管径胸腔引流管在肺叶切除术后的临床应用比较. 中华胸部外科电子杂志, 2016, 3(3): 156-159.
22.	王光锁, 王正, 王健, 等. 单孔全胸腔镜手术:单中心连续 106 例回归分析. 中国内镜杂志, 2014, 20(2): 118-123.
23.	张毅, 支修益. 微创外科手术治疗早期肺癌. 首都医科大学学报, 2015, 36(6): 992-997.
24.	何建行. 微创伤胸外科手术历史、现状和未来. 国际病理科学与临床志, 2013, 33(1): 1-7.
25.	夏燕, 常淑文, 叶敬霆, 等. 快速康复外科在肺癌手术患者中应用效果的 meta 分析. 中国肺癌杂志, 2016, 19(12): 827-836.

1. 刘成武, 刘伦旭. 肺癌微创外科治疗进展. 中华胸部外科电子杂志, 2016, 3(2): 65-69.
2. 吴一旻, 柴莹. 单孔胸腔镜在肺癌外科中的应用进展. 国际外科学杂志, 2016, 43(5): 357-360.
3. 刘成武, 刘伦旭. 单孔胸腔镜: 微创肺癌切除的再次升华. 中国肺癌杂志, 2014, 17(7): 527-530.
4. Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis, 2014, 6(1): 14-21.
5. Sihoe AD. Uniportal video-assisted thoracic (VATS) lobectomy. Ann Cardiothorac Surg, 2016, 5(2): 133-144.
6. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
7. 中国加速康复外科专家组. 中国加速康复外科围手术期管理专家共识(2016). 中华外科杂志, 2016, 54(6): 413-418.
8. 多学科围手术期气道管理专家共识(2016 年版)专家组. 多学科围手术期气道管理专家共识(2016 年版). 中国胸心血管外科临床杂志, 2016, 23(7): 641-645.
9. 石远凯, 孙燕, 主编. 临床肿瘤内科手册. 第 6 版. 北京: 人民卫生出版社, 2015. 205-207.
10. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
11. 任冠华, 范亚光, 赵永成, 等. 低剂量螺旋 CT 肺癌筛查研究进展. 中国肺癌杂志, 2013, 16(10): 553-558.
12. 车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
13. Andrews WG, Paul S. Techniques of video-assisted thoracoscopic surgery lobectomy and critical review of published data. Future Oncol, 2016, 12(23s): 31-33.
14. Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
15. Gonzalez-Rivas D, Fieira E, Mendez L, et al. Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. Eur J Cardiothorac Surg, 2012, 42(6): e169-e171.
16. 邓豫, 郝志鹏, 付向宁. “精准医疗”理念下单孔VATS肺癌根治术的发展现状、应用细节和展望. 中国肺癌杂志, 2016, 19(6): 371-376.
17. 向润, 谢天鹏, 杨晓军, 等. 开放肺叶切除术后切口镇痛泵的临床效果. 中华胸心血管外科杂志, 2015, 31(1): 43, 54.
18. 尹逊亮, 周勇安, 赵宁, 等. 单孔及多孔法胸腔镜手术治疗周围型非小细胞肺癌临床疗效的病例对照研究. 中国胸心血管外科临床杂志, 2016, 23(11): 1044-1049.
19. 朱启航, 肖海平, 何哲, 等. 3 种电视胸腔镜下手术治疗非小细胞肺癌早期创伤反应的比较. 实用医学杂志, 2016, 32(2): 231-235.
20. Lin Y, Zheng W, Zhu Y, et al. Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study. J Thorac Dis, 2016, 8(6): 1290-1296.
21. 马俊杰,高德军. 不同管径胸腔引流管在肺叶切除术后的临床应用比较. 中华胸部外科电子杂志, 2016, 3(3): 156-159.
22. 王光锁, 王正, 王健, 等. 单孔全胸腔镜手术:单中心连续 106 例回归分析. 中国内镜杂志, 2014, 20(2): 118-123.
23. 张毅, 支修益. 微创外科手术治疗早期肺癌. 首都医科大学学报, 2015, 36(6): 992-997.
24. 何建行. 微创伤胸外科手术历史、现状和未来. 国际病理科学与临床志, 2013, 33(1): 1-7.
25. 夏燕, 常淑文, 叶敬霆, 等. 快速康复外科在肺癌手术患者中应用效果的 meta 分析. 中国肺癌杂志, 2016, 19(12): 827-836.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Uniportal versus multiportal video-assisted thoracoscopic lobectomy under the concept of enhanced recovery after surgery: A case control study

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