Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido.
Ann Thorac Cardiovasc Surg. 2021 Apr 20;27(2):91-96. doi: 10.5761/atcs.oa.20-00142. Epub 2020 Oct 1.
Single-port video-assisted thoracoscopic (VATS) pulmonary wedge resection was reported in 2004. We started using single-port VATS (SPVATS) pulmonary wedge resection in 2017 and compared results between conventional three-port VATS (VATS group) and SPVATS (SPVATS group).
We identified 145 consecutive patients with VATS group and SPVATS group. Perioperative characteristics including pain and the number of stapler cartridges used were examined as the surgical outcomes, retrospectively.
In all, 66 cases of SPVATS group and 79 cases of VATS group pulmonary wedge resection were compared. The rate of epidural anesthesia (p <0.0001) was significantly higher and operative time (p <0.0001) was significantly longer with VATS group than with SPVATS group. The number of stapler cartridges used, duration of drain insertion, and rate of postoperative complications did not differ significantly between groups. Average numerical rating scale (NRS) score on postoperative day 1 and postoperative day 7 (p <0.0001 each), maximum NRS score on postoperative day 7 (p = 0.0082) and amount of 25 mg tramadol (p = 0.0062) were significantly lower in SPVAS group than in VATS group.
Our results suggest that SPVATS pulmonary wedge resection offers better pain control and cost-effectiveness than three-port VATS pulmonary wedge resection. These findings should contribute to the body of evidence for SPVATS.
单孔电视辅助胸腔镜(VATS)肺楔形切除术于 2004 年报道。我们于 2017 年开始使用单孔 VATS(SPVATS)肺楔形切除术,并比较了传统三孔 VATS(VATS 组)和 SPVATS(SPVATS 组)的结果。
我们确定了 145 例连续 VATS 组和 SPVATS 组患者。回顾性地检查了包括疼痛和使用的吻合器钉仓数量在内的围手术期特征作为手术结果。
总共比较了 66 例 SPVATS 组和 79 例 VATS 组的肺楔形切除术。硬膜外麻醉率(p <0.0001)明显高于 SPVATS 组,手术时间(p <0.0001)明显长于 SPVATS 组。使用的吻合器钉仓数量、引流管插入时间和术后并发症发生率在两组之间无显著差异。SPVAS 组术后第 1 天和第 7 天的平均数字评分量表(NRS)评分(p <0.0001)、术后第 7 天的最大 NRS 评分(p = 0.0082)和 25 毫克曲马多的用量(p = 0.0062)均明显低于 VATS 组。
我们的结果表明,SPVATS 肺楔形切除术比三孔 VATS 肺楔形切除术提供更好的疼痛控制和成本效益。这些发现应该为 SPVATS 的证据体系做出贡献。