Use of uniportal VATS in the radical surgical treatment of lung cancer

Abstract

Summary This article analyzed results of surgical treatment of the patients with lung cancer by Uniportal VATS. Material and methods. A retrospective analysis of the direct results of surgical treatment of 286 patients with lung cancer on the basis of a medical center from 2012 to 2017 was carried out. Anatomical lung resections with syste­matic media­stinal lymph node dissection were performed ­using a single-­port video-assisted thoracoscopic method. Results. The share of endoscopic operations for 5 years increased from 6.5% to 51%. Since 2013, we have begun perfor­ming complex sleeve resections by ­using uniportal VATS including bronchial, bronchovascular and carinal sleeve resections. The average operating time was halved over the study period. Intraoperative blood loss with lobectomy averaged 129±14.1 ml. The number of lymph nodes removed is, on average, comparable to open interventions (12.6±0.9), which confirms the adequate volume of lymph node dissection for single-port access and radical lung resection for cancer. Conversions performed in 8.7% of cases. The main reason for the transition to thoraco­tomy is pronounced bleeding, which cannot be stopped endoscopically. Postoperative pain in most patients was not pronounced. The duration of the drainage of the pleural cavity averaged 5.8±0.4 days. Postoperative complications were detected in 16.4% of cases, in 29.8% of them repeated surgical interventions were required. Postope­rative mortality was 1,1%. Сonclusion. Оur experience with Uniportal VATS anatomical resections demonstrates the safety of this method and oncological adequacy. Be­nefits include less trauma, a low rate of postoperative complications and faster patient recovery.