Uniportal <i>versus</i> multiportal video-assisted thoracoscopic lobectomy under the concept of enhanced recovery after surgery: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIANG Run ,  ZHU Jiang , LI Qiang , XIE Tianpeng , YANG Xiaojun ,  HE Jintao

Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P.R.China;

Corresponding?author：

ZHU Jiang, Email: 13008148289@163.com; HE Jintao, Email: HJTabc3@163.com

Keywords：

Enhanced recovery after surgery; lung carcinoma; lobectomy; uniportal video-assisted thoracoscopy

DOI：

10.7507/1007-4848.201705049

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the effect of uniportal and multiportal thoracoscopic lobectomy, and to explore the advantages and applications of uniportal thoracoscopic lobectomy in enhanced recovery after surgery. Methods Totally 169 patients with video-assisted thoracoscopic lobectomy in Department of Thoracic Surgery of Sichuan Cancer Hospital from January to December 2016 were enrolled. There were 99 males and 70 females with age of 60.83±7.24 years. Patients were divided into two groups: a uniportal group (78 patients) and a multiportal group (91 patients) . Patients’ clinical and pathological materials were collected. Postoperative pain, complications and hospital stay, etc of the two groups were compared. Results All patients were successfully discharged without serious postoperative complication or death. Patients in the multiportal group had smaller surgical incisions than that in the uniportal group (3.12±0.73 cm vs. 6.38±1.50 cm, P=0.016). Pain scores at postoperative 24 and 48 hours of the uniportal group were less than those of multiportal group (4.18±1.67 vs. 6.54±1.83, 3.05±1.47 vs. 4.68±1.64, P<0.05). Operation data, postoperative complications and hospital stay were similar in both groups. Conclusion Uniportal video-assisted thoracoscopic lobectomy makes smaller incisions and can further reduce postoperative pain and dosage of morphine. The operation is safe and worthy of wide application in enhanced recoveryafter surgery.

Citation： XIANG Run, ZHU Jiang, LI Qiang, XIE Tianpeng, YANG Xiaojun, HE Jintao. Uniportal versus multiportal video-assisted thoracoscopic lobectomy under the concept of enhanced recovery after surgery: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(4): 284-288. doi: 10.7507/1007-4848.201705049 Copy

1.	劉成武, 劉倫旭. 肺癌微創外科治療進展. 中華胸部外科電子雜志, 2016, 3(2): 65-69.
2.	吳一旻, 柴瑩. 單孔胸腔鏡在肺癌外科中的應用進展. 國際外科學雜志, 2016, 43(5): 357-360.
3.	劉成武, 劉倫旭. 單孔胸腔鏡: 微創肺癌切除的再次升華. 中國肺癌雜志, 2014, 17(7): 527-530.
4.	Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis, 2014, 6(1): 14-21.
5.	Sihoe AD. Uniportal video-assisted thoracic (VATS) lobectomy. Ann Cardiothorac Surg, 2016, 5(2): 133-144.
6.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
7.	中國加速康復外科專家組. 中國加速康復外科圍手術期管理專家共識(2016). 中華外科雜志, 2016, 54(6): 413-418.
8.	多學科圍手術期氣道管理專家共識(2016 年版)專家組. 多學科圍手術期氣道管理專家共識(2016 年版). 中國胸心血管外科臨床雜志, 2016, 23(7): 641-645.
9.	石遠凱, 孫燕, 主編. 臨床腫瘤內科手冊. 第 6 版. 北京: 人民衛生出版社, 2015. 205-207.
10.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
11.	任冠華, 范亞光, 趙永成, 等. 低劑量螺旋 CT 肺癌篩查研究進展. 中國肺癌雜志, 2013, 16(10): 553-558.
12.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
13.	Andrews WG, Paul S. Techniques of video-assisted thoracoscopic surgery lobectomy and critical review of published data. Future Oncol, 2016, 12(23s): 31-33.
14.	Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
15.	Gonzalez-Rivas D, Fieira E, Mendez L, et al. Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. Eur J Cardiothorac Surg, 2012, 42(6): e169-e171.
16.	鄧豫, 郝志鵬, 付向寧. “精準醫療”理念下單孔VATS肺癌根治術的發展現狀、應用細節和展望. 中國肺癌雜志, 2016, 19(6): 371-376.
17.	向潤, 謝天鵬, 楊曉軍, 等. 開放肺葉切除術后切口鎮痛泵的臨床效果. 中華胸心血管外科雜志, 2015, 31(1): 43, 54.
18.	尹遜亮, 周勇安, 趙寧, 等. 單孔及多孔法胸腔鏡手術治療周圍型非小細胞肺癌臨床療效的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(11): 1044-1049.
19.	朱啟航, 肖海平, 何哲, 等. 3 種電視胸腔鏡下手術治療非小細胞肺癌早期創傷反應的比較. 實用醫學雜志, 2016, 32(2): 231-235.
20.	Lin Y, Zheng W, Zhu Y, et al. Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study. J Thorac Dis, 2016, 8(6): 1290-1296.
21.	馬俊杰,高德軍. 不同管徑胸腔引流管在肺葉切除術后的臨床應用比較. 中華胸部外科電子雜志, 2016, 3(3): 156-159.
22.	王光鎖, 王正, 王健, 等. 單孔全胸腔鏡手術:單中心連續 106 例回歸分析. 中國內鏡雜志, 2014, 20(2): 118-123.
23.	張毅, 支修益. 微創外科手術治療早期肺癌. 首都醫科大學學報, 2015, 36(6): 992-997.
24.	何建行. 微創傷胸外科手術歷史、現狀和未來. 國際病理科學與臨床志, 2013, 33(1): 1-7.
25.	夏燕, 常淑文, 葉敬霆, 等. 快速康復外科在肺癌手術患者中應用效果的 meta 分析. 中國肺癌雜志, 2016, 19(12): 827-836.

1. 劉成武, 劉倫旭. 肺癌微創外科治療進展. 中華胸部外科電子雜志, 2016, 3(2): 65-69.
2. 吳一旻, 柴瑩. 單孔胸腔鏡在肺癌外科中的應用進展. 國際外科學雜志, 2016, 43(5): 357-360.
3. 劉成武, 劉倫旭. 單孔胸腔鏡: 微創肺癌切除的再次升華. 中國肺癌雜志, 2014, 17(7): 527-530.
4. Liu CY, Lin CS, Shih CH, et al. Single-port video-assisted thoracoscopic surgery for lung cancer. J Thorac Dis, 2014, 6(1): 14-21.
5. Sihoe AD. Uniportal video-assisted thoracic (VATS) lobectomy. Ann Cardiothorac Surg, 2016, 5(2): 133-144.
6. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
7. 中國加速康復外科專家組. 中國加速康復外科圍手術期管理專家共識(2016). 中華外科雜志, 2016, 54(6): 413-418.
8. 多學科圍手術期氣道管理專家共識(2016 年版)專家組. 多學科圍手術期氣道管理專家共識(2016 年版). 中國胸心血管外科臨床雜志, 2016, 23(7): 641-645.
9. 石遠凱, 孫燕, 主編. 臨床腫瘤內科手冊. 第 6 版. 北京: 人民衛生出版社, 2015. 205-207.
10. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
11. 任冠華, 范亞光, 趙永成, 等. 低劑量螺旋 CT 肺癌篩查研究進展. 中國肺癌雜志, 2013, 16(10): 553-558.
12. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
13. Andrews WG, Paul S. Techniques of video-assisted thoracoscopic surgery lobectomy and critical review of published data. Future Oncol, 2016, 12(23s): 31-33.
14. Gonzalez D, Paradela M, Garcia J, et al. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg, 2011, 12(3): 514-515.
15. Gonzalez-Rivas D, Fieira E, Mendez L, et al. Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. Eur J Cardiothorac Surg, 2012, 42(6): e169-e171.
16. 鄧豫, 郝志鵬, 付向寧. “精準醫療”理念下單孔VATS肺癌根治術的發展現狀、應用細節和展望. 中國肺癌雜志, 2016, 19(6): 371-376.
17. 向潤, 謝天鵬, 楊曉軍, 等. 開放肺葉切除術后切口鎮痛泵的臨床效果. 中華胸心血管外科雜志, 2015, 31(1): 43, 54.
18. 尹遜亮, 周勇安, 趙寧, 等. 單孔及多孔法胸腔鏡手術治療周圍型非小細胞肺癌臨床療效的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(11): 1044-1049.
19. 朱啟航, 肖海平, 何哲, 等. 3 種電視胸腔鏡下手術治療非小細胞肺癌早期創傷反應的比較. 實用醫學雜志, 2016, 32(2): 231-235.
20. Lin Y, Zheng W, Zhu Y, et al. Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study. J Thorac Dis, 2016, 8(6): 1290-1296.
21. 馬俊杰,高德軍. 不同管徑胸腔引流管在肺葉切除術后的臨床應用比較. 中華胸部外科電子雜志, 2016, 3(3): 156-159.
22. 王光鎖, 王正, 王健, 等. 單孔全胸腔鏡手術:單中心連續 106 例回歸分析. 中國內鏡雜志, 2014, 20(2): 118-123.
23. 張毅, 支修益. 微創外科手術治療早期肺癌. 首都醫科大學學報, 2015, 36(6): 992-997.
24. 何建行. 微創傷胸外科手術歷史、現狀和未來. 國際病理科學與臨床志, 2013, 33(1): 1-7.
25. 夏燕, 常淑文, 葉敬霆, 等. 快速康復外科在肺癌手術患者中應用效果的 meta 分析. 中國肺癌雜志, 2016, 19(12): 827-836.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Uniportal versus multiportal video-assisted thoracoscopic lobectomy under the concept of enhanced recovery after surgery: A case control study

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content