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- Title
Subxiphoid versus intercostal uniportal video-assisted thoracoscopic surgery for bilateral lung resections: a single-institution experience.
- Authors
Cai, Haomin; Xie, Dong; Sawalhi, Samer Al; Jiang, Lei; Zhu, Yuming; Jiang, Gening; Zhao, Deping
- Abstract
Open in new tab Download slide Open in new tab Download slide OBJECTIVES Subxiphoid uniportal video-assisted thoracoscopic surgery (SUVATS) is a technically difficult and challenging operation that can help decrease pain around the incision after traditional intercostal uniportal video-assisted thoracoscopic surgery (IUVATS), and can also treat bilateral lesions through the same incision. We aimed to compare perioperative outcomes and pain scores after SUVATS and IUVATS in patients receiving synchronous treatment of bilateral lung lesions. METHODS Patients who received SUVATS and IUVATS bilateral lung resections from September 2014 to February 2018 were analysed. Ultimately a total of 381 cases were analysed after using one-to-one propensity score matching to match baseline characteristics between the 2 groups. RESULTS The 381 patients included 56 with SUVATS and 325 with IUVATS. After matching, 54 SUVATS and 54 IUVATS cases were analysed. The 2 groups had similar preoperative factors and did not differ with respect to duration of chest tube placement, length of stay in hospital and incidence of postoperative complications. SUVATS was associated with a significantly longer operative time (212.3 vs 154.6 min, P < 0.001) and more blood loss (190.9 vs 72.7 ml, P < 0.001), lower pain score on the first day after operation (2.6 vs 3.0, P = 0.03) and before discharge (0.8 vs 1.4, P < 0.001). Furthermore, less patients in group SUVATS requested for additional analgesic therapy (P = 0.03). CONCLUSIONS Compared with IUVATS, despite the longer operative time and greater blood loss, SUVATS for bilateral lung lesions is a safe surgical procedure associated with significantly less postoperative pain and a similar incidence of postoperative complications in selected patients.
- Subjects
CHEST endoscopic surgery; LUNG surgery; SURGICAL complications; PROPENSITY score matching; POSTOPERATIVE pain; LOBECTOMY (Lung surgery)
- Publication
European Journal of Cardio-Thoracic Surgery, 2020, Vol 57, Issue 2, p343
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezz206