Single-incision thoracoscopic lobectomy and segmentectomy with radical lymph node dissection

Ann Thorac Surg. 2013 Sep;96(3):977-82. doi: 10.1016/j.athoracsur.2013.05.002. Epub 2013 Jul 16.

Abstract

Background: Reports of single-incision thoracoscopic lobectomy and segmentectomy are rare. In this article, we present our experience with single-incision thoracoscopic lobectomy and segmentectomy and radical mediastinal lymph node dissection.

Methods: Nineteen patients with early-stage malignancy or benign lung disease were treated with single-incision thoracoscopic lobectomy and segmentectomy at our institution between November 2010 and May 2012. The surgical approach began with a single incision at the fifth or sixth intercostal space at the anterior axillary line. A 10-mm video camera and working instruments were used at the same time in this incision site throughout the surgery. The perioperative variables and outcomes were collected and analyzed retrospectively.

Results: For the 19 patients included in the final analysis, 14 lobectomies and 5 segmentectomies were performed successfully without need for conversion. Among the 19 patients who underwent single-port video-assisted thoracoscopic surgery (VATS), 15 cases of cancer and 4 cases of benign pulmonary disease were noted. The mean operative time was 156±46 minutes, and the median number of lymph nodes retrieved was 22.9±9.8. Average blood loss was 38.4±25.9 mL. There were no deaths 30 days after surgery, and 2 cases of atelectasis were observed.

Conclusions: Single-port VATS lobectomy and segmentectomy is safe and feasible for selected patients.

Keywords: 10.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Bronchiectasis / pathology
  • Bronchiectasis / surgery
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymph Node Excision / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Operative Time
  • Pain, Postoperative / physiopathology
  • Patient Safety
  • Pneumonectomy / methods*
  • Retrospective Studies
  • Risk Assessment
  • Thoracic Surgery, Video-Assisted / methods*
  • Thoracoscopy / methods*
  • Treatment Outcome