Bertolaccini Luca, Rocco Gaetano
Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy.
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
J Thorac Dis. 2019 Sep;11(Suppl 16):S2050-S2052. doi: 10.21037/jtd.2019.02.35.
In the last decade, uniportal VATS has increasingly been used for major lung resections as it has revolutionised the way thoracic surgeons treat pulmonary lesions. Uniportal VATS has represented an authentic innovation in thoracic surgery because it represents an ideal link between reduced morbidity and enhanced recovery. From the first feasibility studies, Uniportal VATS has been assessed in terms of postoperative morbidity, mortality, and overall oncologic value yielding similar outcomes compared to open thoracotomy or three-port VATS. The Uniportal VATS Interest Group (UVIG) is a working group inside the European Society of Thoracic Surgeons (ESTS) with a particular interest in Uniportal VATS as the preferred approach to intrathoracic conditions amenable to surgical diagnosis and treatment. The first aim of UVIG was to define a consensus statement on the indications and techniques of uniportal VATS. The first consensus paper among international experts in uniportal VATS lobectomy was obtained through a Delphi process through three rounds of voting to enhance its validity. The Delphi process was used to define the procedure and to optimise the indications, perioperative management and training of Uniportal VATS. The main features of this process including the anonymity of participants, the iterative process, and, controlled feedback were reported in the consensus statement.
在过去十年中,单孔电视辅助胸腔镜手术(VATS)越来越多地被用于大型肺切除手术,因为它彻底改变了胸外科医生治疗肺部病变的方式。单孔VATS代表了胸外科领域一项真正的创新,因为它是降低发病率和促进康复之间的理想纽带。从最初的可行性研究开始,单孔VATS就已在术后发病率、死亡率和整体肿瘤学价值方面进行了评估,与开胸手术或三孔VATS相比,结果相似。单孔VATS兴趣小组(UVIG)是欧洲胸外科医师协会(ESTS)内部的一个工作组,对单孔VATS特别感兴趣,将其作为适合手术诊断和治疗的胸内疾病的首选方法。UVIG的首要目标是就单孔VATS的适应症和技术制定一份共识声明。通过三轮投票的德尔菲法,在国际单孔VATS肺叶切除专家中获得了第一篇共识论文,以提高其有效性。德尔菲法用于定义该手术,并优化单孔VATS的适应症、围手术期管理和培训。该过程的主要特点,包括参与者的匿名性、迭代过程和可控反馈,都在共识声明中有所报道。