Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, University College of London Hospitals, London, UK.
Thorac Cancer. 2019 Jun;10(6):1334-1339. doi: 10.1111/1759-7714.13040. Epub 2019 May 15.
Uniportal video-assisted thoracic surgery (VATS) has undergone significant development in recent years, yet its usefulness and value in the treatment of lung cancer remains controversial. We investigated the effect of uniportal VATS surgery for reducing postoperative thorax drainage in lung cancer patients.
The data of primary lung cancer patients who underwent VATS anatomical lung resection at the China National Cancer Center by a single surgeon were retrospectively collected. After propensity score matched analysis, 492 patients (246 uniportal VATS, 246 multiportal VATS) were included in the study. The clinicopathologic and surgery-related features, including drainage volume, were compared. Student's t and chi-square tests were used; all tests were two-sided.
Patients in the two groups had similar demographic and clinicopathological features. Patients who underwent uniportal VATS surgery had significantly lower postoperative thorax drainage (830.0 ± 666.0 mL vs. 1014.5 ± 616.9 mL, P = 0.002) and a comparatively lower rate of unplanned return to the operating room (0 vs. 0.8%; P = 0.156) than multiportal VATS patients. The surgical duration, blood loss, number of lymph nodes dissected, postoperative complications, and length of hospital stay were similar between the groups.
Uniportal VATS could reduce postoperative thorax drainage and the risk of unplanned return to the operating room for lung cancer patients. This study included the largest sample by a single surgeon and our results suggest the potential value of uniportal VATS for the faster recovery of lung cancer patients.
近年来，单孔电视辅助胸腔镜手术（VATS）有了显著的发展，但在肺癌治疗中的有效性和价值仍存在争议。我们研究了单孔 VATS 手术在减少肺癌患者术后胸腔引流方面的效果。
回顾性收集了由同一位外科医生在中国国家癌症中心行 VATS 解剖性肺切除术的原发性肺癌患者的数据。经过倾向评分匹配分析，共有 492 例患者（246 例单孔 VATS，246 例多孔 VATS）纳入本研究。比较了两组患者的临床病理和手术相关特征，包括引流量。采用 Student's t 检验和卡方检验；所有检验均为双侧检验。
两组患者的人口统计学和临床病理特征相似。行单孔 VATS 手术的患者术后胸腔引流明显减少（830.0±666.0 mL 比 1014.5±616.9 mL，P=0.002），且计划性返回手术室的比例也较低（0 比 0.8%，P=0.156）。两组患者的手术时间、出血量、淋巴结清扫数量、术后并发症和住院时间相似。
单孔 VATS 可减少肺癌患者术后胸腔引流和计划性返回手术室的风险。本研究为单外科医生开展的最大样本研究，结果提示单孔 VATS 可能有助于肺癌患者更快康复。
