Objective To investigate the optimal procedure and short-term efficacy of uniportal video-assisted thoracic surgery (U-VATS) lobectomy for lung cancer. Methods The clinical data of 61 patients who underwent lobectomy using U-VATS by the same surgeon between April 2016 and February 2017 were retrospectively analyzed. There were 50 patients (40 males and 10 females, aged 61.4±6.6 years) with conventional procedure. And there were 60 patients (45 males and 15 females, aged 59.2±9.7 years) utilizing multiportal thoracoscopic surgery (M-VATS) during this period. Results The baseline characteristics in both groups such as age, gender, body mass index, comorbidity and tumor size were comparable (P>0.05). There was no postoperative mortality or conversion to thoracotomy in the study. The parameters such as operative time, blood loss, harvested lymph nodes, duration of chest tube drainage, and length of postoperative hospital stay were similar in both groups (P>0.05). However, there was a statistical difference in pain score at 12 h after surgery in favor of the U-VATS approach (3.2vs.4.3, P=0.04). Moreover, subgroup analysis indicated that the operation time using single-direction U-VATS was noticeably shorter than that in both conventional U-VATS and M-VATS (76.4 minvs.125.8 minvs.105.6 min, P<0.05). However, further analysis was not performed because of small sample. Conclusion The short-term efficacy of U-VATS lobectomy for lung cancer is noninferior to M-VATS, meanwhile, single-direction U-VATS lobectomy is feasible followed by shortened operative time.
ObjectiveTo investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for the patients with chronic obstructive pulmonary emphysema (COPE). MethodsWe retrospectively analyzed clinical data of eleven male patients with bilateral COPE and bullae in Xuzhou Central Hospital Affiliated to Southeast University from January 2013 through June 2014. All the patients underwent staged bilateral single-port thoracoscopic LVRS with their age of 60.27± 12.11 years. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin. Besides, the pulmonary function, blood gas assay, 6-minute walk distance (6-MWD), and life quality evaluated by short form 36 Health survey questionnaire (SF-36) were recorded before and after LVRS respectively. ResultsAll the patients survived after surgery. Chest tube drainage time was 9.09± 1.31 days. Postoperative hospital stay was 15.73± 2.75 days. There were 5 patients with persistent air leakage and 7 patients with pulmonary infection who were cured finally. The pulmonary function, arterial partial pressure of oxygen(PaO2), 6-MWD and life quality after unilateral or bilateral LVRS improved than those before surgery in postoperative 3 months. However, there was no statistical difference in outcomes between unilateral and bilateral LVRS patients. ConclusionStaged bilateral single-port thoracoscopic LVRS could improve short-term life quality of patients with COPE.
ObjectiveTo investigate the clinical characteristics of uniportal and three-port subxiphoid video-assisted thoracoscopic surgery (XVATS) extended thymectomy.MethodsThe clinical data of 60 consecutive patients of XVATS thymectomy in Xuzhou Central Hospital from January 2017 to May 2019 were retrospectively analyzed. There were 29 males and 31 females, with an average age of 53.1 (27.0-76.0) years. The patients were divided into an uniportal XVATS group (30 patients) and a three-port XVATS group (30 patients). The clinical effectiveness was compared between the two groups.ResultsThere was no significant difference in age, sex, body mass index, tumor size, intraoperative blood loss, postoperative time of thoracic tube indwelling and thoracic drainage, or postoperative hospitalization time between the two groups (P>0.05). There was no perioperative mortality, conversion to thoracotomy, thrombosis or mediastinal infection. The operation time of the uniportal XVATS group was significantly longer than that of the three-port group (87.5±19.0 min vs. 75.8±15.7 min, P=0.012). Besides, patients in the uniportal group had significantly lower pain score during 3-14 postoperative days than that of the three-port group (P=0.001).ConclusionUniportal XVATS extended thymectomy is feasible with less pain as compared with the patients using three-port XVATS, but it needs longer operation time at initial stage.