Single-port video-assisted thoracoscopic pulmonary segmentectomy: a report on 30 cases

• Published in: European journal of cardio-thoracic surgery 2016-01, Vol.49 (suppl_1), p.i42-i47
• Main Authors: Han, Kook Nam, Kim, Hyun Koo, Lee, Hyun Joo, Choi, Young Ho
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Feasibility Studies; Female; Humans; Lung Diseases - surgery; Male; Middle Aged; Pneumonectomy - instrumentation; Pneumonectomy - methods; Thoracic Surgery, Video-Assisted - instrumentation; Thoracic Surgery, Video-Assisted - methods; Treatment Outcome
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezv406

OBJECTIVES This study aimed to evaluate the feasibility of a single-port video-assisted thoracoscopic surgery for pulmonary segmentectomy in patients with malignant or benign lung diseases. METHODS Thirty patients (17 women; mean age, 61.7 ± 10.9 years) who underwent a single-port thoracoscopic segmentectomy were consecutively included in this study. A 2- to 4-cm incision was made at the fifth intercostal space on the anterior or posterior axillary line, depending on the tumour location. We investigated the postoperative outcomes according to the size of the incision (2 vs 3–4 cm) or the location of segmentectomy. RESULTS Fifteen primary lung cancers, 5 metastatic lung cancers, 1 pulmonary sarcoma, 7 cases of inflammatory lung disease and 2 benign lung tumours were diagnosed. A 3- to 4-cm incision was used in 16 patients (53.3%), and a 2-cm incision in 14 patients. The most frequent segment removed was the left upper division (9 patients, 30%). A single-port thoracoscopic segmentectomy was completed in all of the patients except one (96.7%). This 1 patient underwent lobectomy instead because the lesion was not found in the initial segment removed. The mean operation time was 159 ± 56 min, and no significant difference in the size of incision was observed (P = 0.651). The right middle and superior segments tended to require shorter operation times (97.1 ± 44.9 min) than the other segments (p < 0.001). One patient died (3.3%) because of septic shock. The chest tube drain was removed 4.6 ± 1.6 days after the operation. CONCLUSIONS This study results suggest that a single-port thoracoscopic surgery might be a feasible option for pulmonary segmentectomy with acceptable postoperative outcomes in the early stages of lung cancer or for benign lung disease.