From the Faculty of Medicine, McGill University, Montréal, Que. (Lorange); the Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University, Montréal, Que. (Katz, Spicer); the Division of General Surgery, Department of Surgery, University of British Columbia, Vancouver, B.C. (Huynh).
Can J Surg. 2024 Mar 28;67(2):E142-E148. doi: 10.1503/cjs.010622. Print 2024 Jan-Feb.
Video-assisted thoracic surgery (VATS) can be performed through 1 or more intercostal or subxiphoid ports. The aim of this study was to evaluate whether number and location of ports had an impact on early perioperative outcomes and postoperative pain after anatomical lung resection (ALR).
A search of the departmental electronic database identified all patients who underwent VATS ALR between June 2018 and June 2019. We stratified patients according to the surgical approach: 2-port VATS, 3-port VATS, and subxiphoid VATS. We extracted demographic and clinicopathologic data. We used univariate analysis with unpaired tests and χ tests to compare these variables between the subgroups.
We included 201 patients in the analysis. When patients were stratified by surgical approach, there was no difference in terms of age, disease load, length of surgery, postoperative complications, duration of pleural drainage, and length of hospital stay. Postoperative pain and morphine equivalent usage were also comparable between the groups. According to these results, number and location of VATS ports seemingly has no clinical impact on early postoperative outcomes. Limitations of the study include its retrospective nature, small sample size, and short follow-up interval.
Our results suggest that incision location and the number of VATS ports is not associated with differences in the incidence of perioperative complications or postoperative pain. Given the limitations described above, further studies with longer follow-up intervals are required to explore the lasting impact of this surgical approach on quality of life.
电视辅助胸腔镜手术 (VATS) 可通过 1 个或多个肋间或剑突下入路进行。本研究旨在评估切口位置和数量对解剖性肺切除术 (ALR) 后早期围手术期结局和术后疼痛的影响。
通过部门电子数据库检索，确定了 2018 年 6 月至 2019 年 6 月期间接受 VATS-ALR 的所有患者。我们根据手术方法对患者进行分层：2 端口 VATS、3 端口 VATS 和剑突下入路 VATS。我们提取了人口统计学和临床病理学数据。我们使用单变量分析和独立样本 t 检验和 χ 检验来比较这些变量在亚组之间的差异。
我们对 201 名患者进行了分析。当根据手术方法对患者进行分层时，年龄、疾病负荷、手术时间、术后并发症、胸腔引流时间和住院时间在各组之间无差异。术后疼痛和吗啡等效用量也无差异。根据这些结果，VATS 端口的数量和位置似乎对术后早期结果没有临床影响。该研究的局限性包括其回顾性、样本量小和随访时间短。
我们的结果表明，切口位置和 VATS 端口的数量与围手术期并发症或术后疼痛的发生率无差异。鉴于上述局限性，需要进行更长随访时间的进一步研究，以探讨这种手术方法对生活质量的持久影响。
