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Jin W, Zheng L, Fan X, Wang H, Wang Q, Yang C. A comparison of three-port and four-port Da Vinci robot-assisted thoracoscopic surgery for lung cancer: a retrospective study. J Cardiothorac Surg 2024; 19:377. [PMID: 38926727 DOI: 10.1186/s13019-024-02920-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND At present, research comparing the short-term postoperative outcomes of anatomical resection in lung cancer under different ports of da Vinci robot-assisted surgery is insufficient. This report aimed to compare the outcomes of three-port and four-port da Vinci robot-assisted thoracoscopic surgery for radical dissection of lung cancer. METHODS 171 consecutive patients who presented to our hospital from January 2020 to October 2021 with non-small cell lung cancer and treated with da Vinci robot-assisted thoracoscopic surgery for radical resection of lung cancer were retrospectively collected and divided into the three-port group (n = 97) and the four-port group (n = 74). The general clinical data, perioperative data and life quality were individually compared between the two groups. RESULTS All the 171 patients successfully underwent surgeries. Compared to the four-port group, the three-port group had comparable baseline characteristics in terms of age, sex, tumor location, tumor size, history of chronic disease, pathological type, and pathological staging. The three-port group also had shorter operation time, less intraoperative blood loss, lower chest tube drainage volume, shorter postoperative hospitalization stay durations, but showed no statistically significant difference (P > 0.05). Postoperative 24, 48 and 72 h visual analogue scale pain scores were lower in the three-port group (p < 0.001). No significant difference was observed between the two groups in the hospitalization costs (P = 0.664), number or stations of total lymph node dissected (p > 0.05) and postoperative respiratory complications (P > 0.05). CONCLUSIONS The three-port robot-assisted thoracoscopic surgery is safe and effective and took better outcomes than the four-port robot-assisted thoracoscopic surgery in non-small cell lung cancer.
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Affiliation(s)
- Wenjian Jin
- Department of Hepatopancreatobiliary Surgery, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
| | - Liang Zheng
- Department of Thoracic Surgery, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
| | - Xiao Fan
- Department of Thoracic Surgery, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
| | - Hui Wang
- Department of Pathology, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
| | - Qianyun Wang
- Department of Thoracic Surgery, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China
| | - Chen Yang
- Department of Thoracic Surgery, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.
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Lorange JP, Katz A, Tankel J, Huynh C, Spicer J. Comparing immediate postoperative outcomes of different VATS approaches for anatomical lung resection: a single-centre retrospective study. Can J Surg 2024; 67:E142-E148. [PMID: 38548299 PMCID: PMC10980531 DOI: 10.1503/cjs.010622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND 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). METHODS 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 t tests and χ2 tests to compare these variables between the subgroups. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Justin-Pierre Lorange
- 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)
| | - Amit Katz
- 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)
| | - James Tankel
- 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).
| | - Caroline Huynh
- 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)
| | - Jonathan Spicer
- 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)
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Dai Z, Li Y, Mi X, Yang Z, Gao J, Liu C, Mei J, Liu L, Pu Q. Comparison of uniport versus triport thoracoscopic single or combined basal segmentectomy for stage IA lung cancer. J Thorac Dis 2023; 15:4216-4228. [PMID: 37691649 PMCID: PMC10482630 DOI: 10.21037/jtd-23-477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/07/2023] [Indexed: 09/12/2023]
Abstract
Background Single or combined basal segmentectomy (CBS), excluding common basal segmentectomy, is the most difficult of all types of segmentectomies. The purpose of this study was to compare the perioperative outcomes and oncological prognosis between uniport thoracoscopic basal segmentectomy (UTBS) and triport thoracoscopic basal segmentectomy (TTBS). Methods This study retrospectively collected 300 patients who underwent thoracoscopic single or CBS at the West China Hospital of Sichuan University from April 2015 to May 2022, including 67 and 233 patients in the UTBS and TTBS groups, respectively. Propensity score matching (PSM) was used to reduce confounding bias between the two groups. The primary outcome was recurrence-free survival (RFS). The secondary outcomes were overall survival (OS) and perioperative outcomes. Results After PSM, the UTBS group (n=64) had significantly less intraoperative blood loss than the TTBS group (n=64) (20 vs. 30 mL, P=0.001). Other perioperative outcomes, including the operation time, number of lymph nodes and lymph node stations harvested, duration of chest tube drainage, postoperative hospital stay, and postoperative complications, were comparable. Subgroup analysis demonstrated that the operative time in the group underwent single basal segmentectomy (SBS) was significantly shorter compared to the group underwent CBS (110 vs. 120 min, P=0.002). There were 5 cases of recurrence in the overall cohort and no recurrence in the matched cohort. No deaths were observed in the overall cohort. Therefore, a survival analysis was conducted only for RFS in the overall cohort. The RFS rate and OS rate of the overall cohort were 98.3% and 100%, respectively. The surgical approach (UTBS vs. TTBS) was not an independent risk factor for RFS (HR: 1.120, 95% CI: 0.342-13.051, P=0.879). Conclusions UTBS provided similar perioperative outcomes and oncological prognoses compared to TTBS.
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Affiliation(s)
- Zhangyi Dai
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Yiming Li
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Xingqi Mi
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Zhenyu Yang
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Jiayi Gao
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Chengwu Liu
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Jiandong Mei
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Lunxu Liu
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
| | - Qiang Pu
- Department of Thoracic Surgery, Sichuan University West China Medical Center, Chengdu, China
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Yin Z, Zhu L, Han D, Jin R, Zhang X, Li H. Management of middle lobe veins during single-portal video-assisted thoracoscopic surgery lobectomy via the fifth intercostal approach (case series): why the subcarinal triangular right base angle is helpful. J Thorac Dis 2022; 14:5056-5063. [PMID: 36647504 PMCID: PMC9840040 DOI: 10.21037/jtd-22-716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/29/2022] [Indexed: 12/31/2022]
Abstract
Background The fifth intercostal space is the preferred approach during uniportal video-assisted thoracoscopic surgery (VATS) lobectomy. However, managing the right middle lobe pulmonary vein (RML PV) through this approach is technically challenging for inexperienced surgeons. To facilitate the surgical procedure, we describe our surgical strategy for managing the middle lobe vein via the fifth intercostal space and define the approach [subcarinal triangular right base angle (SCT-RBA)] utilized to manage the middle lobe vein. Case Description Based on the characteristics of uniportal surgery, we designed a new method of managing middle lobar veins via the fifth intercostal approach, which also facilitates the dissection of the subcarinal lymph nodes. We described the short-term surgical outcomes of 7 patients who underwent single-port middle lobe resection from January 2021 to January 2022 in the Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine. No conversion and mortality were observed in 7 patients who underwent single-port VATS middle lobe resection. One patient had bronchial asthma and air leakage, which led to delayed drainage and hospitalization. There were no complications or delayed discharge reported among the other patients. Conclusions Our initial results indicate that this new technique is a feasible strategy to manage the middle lobe veins and facilitate the dissection of subcarinal lymph nodes.
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Affiliation(s)
- Zhengxin Yin
- Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lianggang Zhu
- Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dingpei Han
- Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Runsen Jin
- Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xianfei Zhang
- Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hecheng Li
- Department of Thoracic Surgery, Ruijin Hospital North Campus, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Wang T, Liu X, Chen L, Liang T, Ning X. Clinical Efficacy of Different Thoracoscopic Surgeries for Patients With Non-small Cell Lung Cancer. Front Surg 2022; 9:842047. [PMID: 35242806 PMCID: PMC8885516 DOI: 10.3389/fsurg.2022.842047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this study was to analyze the clinical efficacy of different thoracoscopic procedures in patients with non-small cell lung cancer and their correlation with matrix metalloproteinase-7 mRNA (MMPs-7 mRNA) and soluble major histocompatibility complex class I molecule A (sMICA), as well as their effect on T-cell subsets. Methods A total of 100 patients with non-small cell lung cancer who received different thoracoscopic surgeries were divided into the Control group (three-port thoracoscopic surgery) and the study group (single-port thoracoscopic surgery). The two groups were evaluated to compare the perioperative indicators, MMPs-7 mRNA, sMICA expression levels, T-cell subsets, postoperative pain, complication rates, and prognostic outcomes at 1-year follow-up. Results The operation time, blood loss, drainage tube placement time, incision length, and hospital stay in the study group were less than those in the control group (P < 0.05). There was no significant difference in the number of lymph node dissections between the two groups (P > 0.05). After 3 days, the expression levels of MMPs-7 mRNA and sMICA in the study group were lower than those in the control group (P < 0.05); CD4 +, CD8 +, and CD4 +/CD8 + in the study group were higher than those in the control group (P < 0.05). On days 1, 3, and 5, the visual analog score (VAS) of the study group was lower than that of the control group (P < 0.05); there was no significant difference in the complication rate between the two follow-up groups (P > 0.05), in which all patients completed the follow-up. After 1 year of follow-up, there was no significant difference in the tumor-free survival rate and overall survival rate between the two groups (P > 0.05). Conclusion Compared with three-port thoracoscopic surgery, single-port thoracoscopic surgery can improve perioperative expression, shorten hospital stay, reduce serum tumor micrometastasis levels, improve immune metastasis mechanisms and reduce pain, which is of great significance to patients with non-small cell lung cancer. It is an effective, convenient, and safe surgical option that deserves wide clinical reference.
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Gao Y, Abulimiti A, He D, Ran A, Luo D. Comparison of single- and triple-port VATS for lung cancer: A meta-analysis. Open Med (Wars) 2021; 16:1228-1239. [PMID: 34514169 PMCID: PMC8389499 DOI: 10.1515/med-2021-0333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 12/29/2022] Open
Abstract
Objective To compare the perioperative parameters between single- and triple-port video-assisted thoracoscopic surgery (VATS) lobectomy in the treatment of lung cancer. Methods The Pubmed, Embase, Cochrane library, and the Web of Science databases were electronically searched from inception to September 2019 for all relevant studies. Study quality was evaluated using the Jadad scale or the Newcastle-Ottawa scale. The results were pooled using the generic inverse-variance method and expressed as mean differences or risk ratios, with 95% confidence intervals. Results Three randomized controlled trials (RCTs) and ten cohort studies with 2,278 subjects were included in the meta-analysis. Whether based on RCTs or cohort studies, the pooled results showed no significant difference in the operation time, chest tube duration, intraoperative blood loss, postoperative hospital stays, lymph node dissection number, postoperative drainage volume, and postoperative complications between single- and triple-port VATS lobectomy (P > 0.05). Single-port VATS could relieve postoperative pain better than triple-port VATS, especially in the first day and fifth day (P < 0.05). No evidence of significant publication bias was found (P > 0.05). Conclusion Single-port VATS lobectomy can yield similar perioperative results to those of triple-port VATS lobectomy and is more effective in relieving postoperative pain.
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Affiliation(s)
- Yunfei Gao
- Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China
| | - Abulaiti Abulimiti
- Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China
| | - Dan He
- Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China
| | - Anpeng Ran
- Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China
| | - Dongbo Luo
- Department of Thoracic Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China
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Saiki A, Mizobuchi T, Nagato K, Ishibashi F, Tsuyusaki J, Sugano I. Uniportal video-assisted thoracic surgery and perioperative pirfenidone for lung cancer and idiopathic pulmonary fibrosis: a case report. J Int Med Res 2021; 49:3000605211016998. [PMID: 34521243 PMCID: PMC8447107 DOI: 10.1177/03000605211016998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/21/2021] [Indexed: 11/15/2022] Open
Abstract
Patients with idiopathic pulmonary fibrosis (IPF) occasionally experience acute exacerbations after surgery for lung cancer. Several recent studies have revealed a prophylactic effect of perioperative pirfenidone treatment on postoperative acute exacerbations of IPF in patients with lung cancer. A 75-year-old woman consulted with her pulmonologist because of an IPF shadow detected by follow-up chest computed tomography 2 months after surgical treatment of biliary cancer. Another 7 months later, chest computed tomography showed a 23- × 14-mm nodule located in the right lower lobe with high accumulation of fluorodeoxyglucose detected by positron emission tomography, resulting in a radiological diagnosis of primary lung cancer with IPF. We administered perioperative pirfenidone treatment followed by right lower lobectomy using uniportal video-assisted thoracoscopic surgery after attaining a pathological diagnosis of adenocarcinoma. The patient developed no acute exacerbations of IPF during the postoperative period, and she had no recurrence of lung cancer for 15 months after surgery. We successfully used a combination of perioperative antifibrotic medication and minimally invasive surgery after lung cancer surgery in a patient with IPF.
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Affiliation(s)
- Ayae Saiki
- Department of General Thoracic Surgery, Social Welfare
Organization Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino
Hospital, Chiba, Japan
- Department of Respiratory Medicine, Social Welfare Organization
Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino Hospital,
Chiba, Japan
| | - Teruaki Mizobuchi
- Department of General Thoracic Surgery, Social Welfare
Organization Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino
Hospital, Chiba, Japan
| | - Kaoru Nagato
- Department of General Thoracic Surgery, Social Welfare
Organization Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino
Hospital, Chiba, Japan
| | - Fumihiro Ishibashi
- Department of General Thoracic Surgery, Social Welfare
Organization Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino
Hospital, Chiba, Japan
| | - Junichi Tsuyusaki
- Department of Respiratory Medicine, Social Welfare Organization
Saiseikai Imperial Gift Foundation, Chibaken Saiseikai Narashino Hospital,
Chiba, Japan
| | - Isamu Sugano
- Department of Pathology, Social Welfare Organization Saiseikai
Imperial Gift Foundation, Chibaken Saiseikai Narashino Hospital, Chiba,
Japan
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Abdellateef A, Ma X, Chen Z, Wu L, Cai J, Jiang L. Subxiphoid uniportal thoracoscopic pulmonary segmentectomy for stage I non-small cell lung cancer: Feasibility, quality of life and financial worthiness. Thorac Cancer 2020; 11:1414-1422. [PMID: 32222039 PMCID: PMC7262898 DOI: 10.1111/1759-7714.13392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/08/2020] [Accepted: 02/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background Subxiphoid uniportal video‐assisted thoracoscopic surgery (SVATS) is more technically challenging than intercostal uniportal video‐assisted thoracoscopic surgery (UVATS), especially in more complex procedures such as segmentectomy. We therefore aimed to investigate the worthiness of undertaking the more demanding subxiphoid approach in patients who had undergone anatomical segmentectomy for stage IA non‐small cell lung cancer (NSCLC). Methods A total of 491 patients were included in our study who had undergone anatomical segmentectomy for stage IA non‐small cell lung cancer from September 2014 to April 2018. They were divided into two groups; 278 patients in the UVATS group and 213 patients in the SVATS group. Different perioperative variables, postoperative pain, quality of life and cost were analyzed and compared between both groups. Results The SVATS group showed a significantly longer operative time (P = 0.007) and more operative blood loss than the intercostal group (P = 0.004). There was no significant difference between both groups regarding postoperative drainage, duration of chest tube, postoperative hospital stay, operative conversion or postoperative complications. The SVATS group showed a significantly lower pain score postoperatively (P < 0.001). In addition, the SVATS group showed a significantly better postoperative quality of life score along the first postoperative year (P < 0.001). UVATS segmentectomy appeared to be significantly cheaper than SVATS segmentectomy (P < 0.001). Conclusions SVATS segmentectomy for stage IA lung cancer is a safe procedure that is worth proceeding with as it is associated with better postoperative pain and better quality of life in the first postoperative year. Further studies are recommended to evaluate the actual cost‐effectiveness of SVATS segmentectomy. Key points • Significant findings of the study Subxiphoid uniportal approach for pulmonary segmentectomy is safe and feasible approach. It has better postoperative pain and better quality of life than the uniportal intercostal approach; however, it is more expensive. • What this study adds Subxiphoid uniportal approach for pulmonary segmentectomy gives a better quality of life in Chinese patients than the intercostal approach; however, it is more expensive.
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Affiliation(s)
- Amr Abdellateef
- Department of Cardiothoracic Surgery, Mansoura University Hospital, Mansoura School of Medicine, Mansoura University, Mansoura, Egypt.,Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyu Ma
- Thoracic Surgery Department, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhigang Chen
- Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liang Wu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianqiao Cai
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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