Uniportal vs. multiportal thoracoscopic segmentectomy: a north American study

• Published in: Journal of thoracic disease 2023-02, Vol.15 (2), p.335-347
• Main Authors: Diaz-Gutierrez, Ilitch, Menier, Charles Antoine, Savoie-White, Félix H, Doyle, Jesse E, Wang, Qi, Andrade, Rafael S, Figueroa, Paula Ugalde
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2072-1439; 2077-6624
• DOI: 10.21037/jtd-22-780

Uniportal video-assisted thoracoscopic surgery (VATS) segmentectomy is gaining worldwide acceptance, but experience in North America is still limited. We report a North American multicenter comparison of uniportal multiportal VATS segmentectomy. We performed an institutional review board-exempt retrospective chart review on prospectively collected databases at two North American centers, from January 2012 to December 2020. We included all VATS segmentectomy patients and excluded emergent cases (n=1), patients with incomplete records (n=2), and segmentectomy performed in conjunction with another type of lung resection (n=1). We recorded patient demographics, perioperative data, 30-day postoperative complications and compared outcomes between cohorts. We provided descriptive statistics for each group. We calculated propensity score matching and paired patients 1:1. We defined P values less than 0.05 as statistically significant. We performed a total of 423 VATS segmentectomies, 181 uniportal (42.7%) 242 multiportal (57.2%). Indications for surgery were primary lung cancer (n=339), metastatic (n=41), benign disease (n=40), and other (n=3). We staged 85.1% of patients preoperatively with positron emission tomography-computed tomography (PET-CT) scan according to National Comprehensive Cancer Network (NCCN) guidelines. Propensity score matching generated 156 patients on each group. Operating time was significantly lower in the uniportal group compared to multiportal (130 161 min respectively, P