单孔电视辅助胸腔镜手术治疗肺癌:中国心胸血管外科医师协会(CSTCVS)和中国胸外科医师协会(CATS)共识报告
Uniportal video-assisted thoracic surgery for the treatment of lung cancer: a consensus report from Chinese Society for Thoracic and Cardiovascular Surgery (CSTCVS) and Chinese Association of Thoracic Surgeons (CATS).
作者信息
Han Dingpei, Cao Yuqin, Wu Han, Wang Haifeng, Jiang Lei, Zhao Deping, Yao Feng, Li Shuben, Zhang Chong, Zheng Bin, Fan Junqiang, Liao Yongde, Qiu Bin, Tan Fengwei, Chen Chun, Zhu Yuming, Gao Shugeng, Li Hecheng
机构信息
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
出版信息
Transl Lung Cancer Res. 2020 Aug;9(4):971-987. doi: 10.21037/tlcr-20-576.
Uniportal video-assisted thoracoscopic surgery (UniVATS) has been widely adopted in China, where several ultra-high volume thoracic surgical and training centers are located. The objective of this consensus from Chinese experts was to summarize the current application and give reference for the future development of UniVATS in the treatment of lung cancer. A panel of 41 experts from 21 Chinese hospitals was invited to join this project. The Delphi method was used in this consensus consisting of two rounds of voting. The questionnaire was based on the current clinical evidence. Forty (97.6%) experts completed the 2 rounds of questionnaires. The experts' experience was relatively similar. We defined the UniVATS as monitor-dependent surgery, no use of rib-spreading and single incision less than 4 cm. Tumor with stage of T1-T3 and N0-N2 is considered amenable to UniVATS. Other consensus was reached on several points outlining the safety and feasibility, surgical skills, learning curve, short-term and long-term outcomes for lung cancer, and current application of subxiphoid and nonintubated UniVATS approach. This consensus statement represents a collective agreement among Chinese experts to suggest that UniVATS is an effective alternative to multi-portal approach, although high-level evidence is expected in the future. Some agreements can be referred in the training of young surgeons.
单孔电视辅助胸腔镜手术(UniVATS)在中国已被广泛采用,中国有几个超大型胸外科手术和培训中心。中国专家达成这一共识的目的是总结UniVATS目前在肺癌治疗中的应用情况,并为其未来发展提供参考。邀请了来自21家中国医院的41位专家组成小组参与该项目。本共识采用德尔菲法,包括两轮投票。调查问卷基于当前的临床证据。40位(97.6%)专家完成了两轮问卷调查。专家们的经验相对相似。我们将UniVATS定义为依赖监视器的手术,不使用撑开肋骨,且单一切口小于4厘米。T1-T3期且N0-N2期的肿瘤被认为适合进行UniVATS手术。在安全性和可行性、手术技巧、学习曲线、肺癌的短期和长期疗效以及剑突下和非插管UniVATS手术方法的当前应用等几个方面也达成了其他共识。本共识声明代表了中国专家的集体意见,表明UniVATS是多端口手术的有效替代方法,尽管未来仍需要高级别证据。其中一些共识可用于年轻外科医生的培训。