Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy.
Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey.
Eur J Cardiothorac Surg. 2019 Aug 1;56(2):224-229. doi: 10.1093/ejcts/ezz133.
Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training.
The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds.
Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be ≤4 cm. Agreement was reached on many points outlining the currently accepted definition of a UniVATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions.
The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is the establishment of a UniVATS section inside the ESTS databases.
我们旨在报告通过德尔菲法达成的国际单孔电视辅助胸腔镜手术（UniVATS）肺叶切除术专家共识第一份报告的结果，该共识的目的是定义和规范主要手术步骤，优化其适应证和围手术期管理，并确定有助于未来培训的要素。
工作组的 40 名成员由欧洲胸外科协会（ESTS）的单孔胸腔镜手术兴趣小组（UVIG）自愿召集和组织。采用德尔菲法进行电子共识研究，要求对每个问题达成 75%的共识。经过三轮匿名投票，进行了多次迭代。
来自 18 个国家的 31 名国际专家完成了所有三轮问卷调查。尽管未达到技术人数要求，但大多数应答者都同意 UniVATS 切口的最大尺寸应≤4cm。就目前接受的 UniVATS 肺叶切除术的定义、适应证和禁忌证、围手术期临床管理以及培训和未来研究方向的建议等许多要点达成了一致。
UVIG 共识报告指出，UniVATS 为标准 VATS 技术提供了有效的替代方案。只有更长的随访和随机对照研究才能预测 UniVATS 是否代表了一种针对主要肺切除术的多端口 VATS 的有效替代方法，或者它是否仅应在特定情况下和由特定中心进行。ESTS UVIG 的下一步是在 ESTS 数据库中建立 UniVATS 部分。
