Short-term and long-term outcomes of uniportal versus three portal thoracoscopic radical resection of non-small cell lung cancer: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Tian ¹ , WANG Gaoxiang ² , XU Guangwen ² , XIE Mingran ² , ZHU Xiaodong ³ , JIAN Junling ³ ,  MA Dongchun ^1,3

1. Clinical College of Chest, Anhui Medical University, Hefei, 230061, P. R. China;
2. Department of Thoracic Surgery, Anhui Medical University Affiliated Provincial Hospital, Hefei, 230001, P. R. China;
3. Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, 230061, P. R. China;

Corresponding author：

MA Dongchun, Email: madongchun126@126.com

Keywords：

Thoracoscope; uniportal; non-small cell lung cancer; complication; survive

DOI：

10.7507/1007-4848.202212039

Video：

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Objective To compare the short-term efficacy and long-term survival of patients with non-small cell lung cancer (NSCLC) treated by uniportal or three portal thoracoscopic radical resection. Methods A total of 388 patients who underwent uniportal or three portal thoracoscopic radical resection of lung cancer in the Department of Thoracic Surgery of Anhui Chest Hospital from 2015 to 2016 were analyzed retrospectively. The patients were divided into two groups including an uniportal group and a three portal group according to the procedure. The clinicopathological features, perioperative data and long-term survival of the two groups were compared. Results Finally, we included 205 patients with 105 males and 100 females at an average age of 58.73±10.93 years. There were 102 patients in the uniportal group and 103 patients in the three portal group. There was no statistical difference in clinicopathological features between the two groups (P>0.05). But compared with the three portal group, the uniportal group had less postoperative drainage, shorter postoperative catheterization time and postoperative hospital stay (P<0.05). There was no statistical difference in the number of lymph node dissection stations between the two groups (P=0.058). The pain score at 24 hours after operation in the uniportal group was significantly lower than that in the three portal group (P<0.001). There was no statistical difference in the total incidence of complications and the incidence of pulmonary complications between the two groups (P=0.161 and P=0.275). The median survival period and the 1st, 3rd, and 5th year survival rate in the uniportal group was 63.0 months and 95.0%, 75.2%, 51.5%, respectively. The median survival period and the 1st, 3rd, and 5th year survival rate in the three portal group was 61.0 months and 89.3%, 70.9%, 50.5%, respectively. There was no satistical difference in the survival results between the two groups (P=0.440). Conclusion Uniportal thoracoscopic radical resection of lung cancer is more minimally invasive and safe and effective in the treatment of NSCLC. It can make patients recover faster after operation.

Citation： LI Tian, WANG Gaoxiang, XU Guangwen, XIE Mingran, ZHU Xiaodong, JIAN Junling, MA Dongchun. Short-term and long-term outcomes of uniportal versus three portal thoracoscopic radical resection of non-small cell lung cancer: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(4): 564-568. doi: 10.7507/1007-4848.202212039 Copy

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5.	Zhang F, Xu L, Lu H, et al. Short-term surgical outcomes for lobectomy between robot-assisted thoracic surgery and uniportal video-assisted thoracoscopic surgery. Front Oncol, 2022, (12): 914059.
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11.	陈大庆, 詹必成, 陈剑. 单孔胸腔镜下肺叶解剖切除术对早期非小细胞肺癌的疗效及安全性分析. 中国肿瘤外科杂志, 2020, 12(3): 203-207.
12.	van der Ploeg A, Ayez N, Akkersdijk GP, et al. Postoperative pain after lobectomy: Robot-assisted, video-assisted and open thoracic surgery. J Robot Surg, 2020, 14(1): 131-136.
13.	Hernandez-Vaquero D, Vigil-Escalera C, Pérez-Méndez I, et al. Survival after thoracoscopic surgery or open lobectomy: Systematic review and meta-analysis. Ann Thorac Surg, 2021, 111(1): 302-313.
14.	Chen YY, Huang WL, Chang CC, et al. Uniportal versus multiportal thoracoscopic complex segmentectomy: Propensity matching analysis. Ann Thorac Cardiovasc Surg, 2021, 27(4): 237-243.
15.	Magouliotis DE, Fergadi MP, Spiliopoulos K, et al. Uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer: An updated meta-analysis. Lung, 2021, 199(1): 43-53.
16.	Zhao J, Zeng Q, Li J, et al. Uniportal versus multiportal thoracoscopic sleeve lobectomy for the surgical treatment of centrally located lung cancer: A single institution experience. J Thorac Dis, 2020, 12(12): 7145-7155.
17.	张典钿, 江立群, 冷云华, 等. 单孔与多孔胸腔镜切除右上肺叶治疗早期非小细胞肺癌: 单中心回顾性倾向配比研究. 中国临床医学, 2021, 28(1): 23-26.
18.	Kang DK, Kang MK, Heo W, et al. Single center experience of uniportal VATS anatomical lung resections: Mid-term oncological outcomes. Thorac Cancer, 2021, 12(7): 1006-1013.

1. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
2. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3. Cao W, Chen HD, Yu YW, et al. Changing profiles of cancer burden worldwide and in China: A secondary analysis of the global cancer statistics 2020. Chin Med J (Engl), 2021, 134(7): 783-791.
4. Lim E, Batchelor T, Shackcloth M, et al. Study protocol for video assisted thoracoscopic lobectomy versus conventional open lobectomy for lung cancer, A UK multicentre randomised controlled trial with an internal pilot (the VIOLET study). BMJ Open, 2019, 9(10): e29507.
5. Zhang F, Xu L, Lu H, et al. Short-term surgical outcomes for lobectomy between robot-assisted thoracic surgery and uniportal video-assisted thoracoscopic surgery. Front Oncol, 2022, (12): 914059.
6. Coco D, Leanza S. Current perspective on uniportal and multiportal video-assisted thoracic surgery during lobectomy for lung cancer. Kardiochir Torakochirurgia Pol, 2022, 19(3): 146-151.
7. 冯晓延, 熊荣生, 许可, 等. 单孔与双孔胸腔镜下肺叶切除术治疗非小细胞肺癌的效果比较. 临床医学, 2022, 42(5): 5-7.
8. Zhang J, Zhao H, Lv L, et al. Uniportal thoracoscopic pulmonary lobectomy in the treatment of lung cancer. Pak J Med Sci, 2020, 36(2): 182-186.
9. Mendogni P, Mazzucco A, Palleschi A, et al. 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. Trials, 2021, 22(1): 163.
10. 李强盛, 张雷, 李洪林, 等. 单孔、单操作孔及三孔胸腔镜肺叶切除术治疗早期非小细胞肺癌的临床疗效分析. 中国急救复苏与灾害医学杂志, 2021, 16(4): 407-410.
11. 陈大庆, 詹必成, 陈剑. 单孔胸腔镜下肺叶解剖切除术对早期非小细胞肺癌的疗效及安全性分析. 中国肿瘤外科杂志, 2020, 12(3): 203-207.
12. van der Ploeg A, Ayez N, Akkersdijk GP, et al. Postoperative pain after lobectomy: Robot-assisted, video-assisted and open thoracic surgery. J Robot Surg, 2020, 14(1): 131-136.
13. Hernandez-Vaquero D, Vigil-Escalera C, Pérez-Méndez I, et al. Survival after thoracoscopic surgery or open lobectomy: Systematic review and meta-analysis. Ann Thorac Surg, 2021, 111(1): 302-313.
14. Chen YY, Huang WL, Chang CC, et al. Uniportal versus multiportal thoracoscopic complex segmentectomy: Propensity matching analysis. Ann Thorac Cardiovasc Surg, 2021, 27(4): 237-243.
15. Magouliotis DE, Fergadi MP, Spiliopoulos K, et al. Uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer: An updated meta-analysis. Lung, 2021, 199(1): 43-53.
16. Zhao J, Zeng Q, Li J, et al. Uniportal versus multiportal thoracoscopic sleeve lobectomy for the surgical treatment of centrally located lung cancer: A single institution experience. J Thorac Dis, 2020, 12(12): 7145-7155.
17. 张典钿, 江立群, 冷云华, 等. 单孔与多孔胸腔镜切除右上肺叶治疗早期非小细胞肺癌: 单中心回顾性倾向配比研究. 中国临床医学, 2021, 28(1): 23-26.
18. Kang DK, Kang MK, Heo W, et al. Single center experience of uniportal VATS anatomical lung resections: Mid-term oncological outcomes. Thorac Cancer, 2021, 12(7): 1006-1013.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term and long-term outcomes of uniportal versus three portal thoracoscopic radical resection of non-small cell lung cancer: A retrospective cohort study

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