Abstract
The purpose of this study was to present our current experience with reduced port thoracoscopic surgery (RPTS) for the treatment of mediastinal and pleural disease and thereafter discuss its indications and technical challenges. A total of 11 patients underwent surgery by the RPTS approach for the following conditions: thymoma (n = 2), bronchogenic cyst (n = 2), metastatic pleural tumor, thymic cyst, solitary fibrous tumor, pulmonary sequestration, pericardial cyst, neurinoma, and malignant lymphoma (n = 1). An Endo Relief forceps (Hope Denshi Co, Ltd, Chiba, Japan) was used for three of the surgical procedures. The elements of the data set consisted of gender, age, duration of operation, drain placement, hospital stay, mass location, and mass size. The median surgical time was 45 min (range, 40–78 min). There were no intraoperative complications and no need for a second surgery to open additional ports. The duration until chest tube removal was 1 day for all the cases. The median hospital stay was 4 days (range, 3–6 days). The median mass size was 2.2 cm (range, 1.2–4.2 cm). The median length of skin incision was 2.0 cm (range, 2.0–3.5 cm). In conclusion, RPTS for mediastinal and pleural disease may be a possible alternative approach to conventional multiportal video-assisted thoracoscopic surgery (VATS). Although it is technically plausible and feasible for selected cases, the issues of patient acceptability and cosmetic and oncological results remain to be determined in the future with randomized-controlled trials and long-term follow-up.
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References
Shigemura N, Akashi A, Nakagiri T, Ohta M, Matsuda H (2004) Complete versus assisted thoracoscopic approach: a prospective randomized trial comparing a variety of video-assisted thoracoscopic lobectomy techniques. Surg Endosc 18:1492–7
Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N (2001) Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg 72:362–5
Landreneau RJ, Hazelrigg SR, Mack MJ, Dowling RD, Burke D, Gavlick J et al (1993) Postoperative pain-related morbidity: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg 56:1285–9
Salati M, Brunelli A, Xiume F, Refai M, Sciarra V, Soccetti A et al (2008) Uniportal video-assisted thoracic surgery for pulmonary spontaneous pneumothorax: clinical and economic analysis in comparison to the traditional approach. Interact Cardiovasc Thorac Surg 7:63–6
Rocco G, Martin-Ucar A, Passera E (2004) Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 77:726–728
Jutley RS, Khalil MW, Rocco G (2005) Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg 28:43–46
Berlanga L, Gigirey O (2011) Uniportal video-assisted thoracic surgery for primary spontaneous pneumothorax using a single-incision laparoscopic surgery port: a feasible and safe procedure. Surg Endosc 25:2044–2047
Chen PR, Chen CK, Lin YS, Huang HC, Tsai JS, Chen CY et al (2011) Single-incision thoracoscopic surgery for primary spontaneous pneumothorax. J Cardiothorac Surg 21(6):58
Ishii M, Nishiyama T, Naganuma H, Kaneshiro M, Nakui M, Ozawa S et al (2012) Development of new small diameter forceps for reduced-port surgery. J Jpn Soc Endoscopic Surg 17(2):267–71
Gonzalez D, de la Torre M, Paradela M, Fernandez R, Delgado M, Garcia J et al (2011) Video-assisted thoracic surgery lobectomy: 3-year initial experience with 200 cases. Eur J Cardiothorac Surg 40:21–28
Chen YB, Wu YW, Yang WT, Shi L, Guo XF, Xu ZH et al (2009) Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Chin Med J 122(13):1525–8
Chen CH, Lee SY, Chang H, Liu HC, Chen CH, Huang WC (2012) Technical aspects of single-port thoracoscopic surgery for lobectomy. J Cardiothorac Surg 7:50
Ahn HY, Cho JS, Kim YD, Hoseok I, Lee J (2013) Single-incision video-assisted thoracoscopic surgery for benign mediastinal disease: experiences in single institution. Korean J Thorac Cardiovasc Surg 46(5):388–90
Singhal S, Kaiser LR (2003) Comparison of stages I-II thymoma treated by complete resection with or without adjuvant radiation. Ann Thorac Surg 76:1635–41
Murakawa T, Nakajima J, Kohno T, Tanaka M, Matsumoto J, Takeuchi E et al (2000) Results from surgical treatment for thymoma. 43 years of experience. Jpn J Thorac Cardiovasc Surg 48:89–95
Salati M, Brunelli A, Rocco G (2008) Uniportal video-assisted thoracic surgery for diagnosis and treatment of intrathoracic conditions. Thorac Surg Clin 18(3):305–10
Tamura M, Shimizu Y, Hashizume Y (2013) Pain following thoracoscopic surgery: retrospective analysis between single-incision and three-port video-assisted thoracoscopic surgery. J Cardiothorac Surg 12(8):153
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Tamura, M., Shimizu, Y. & Hashizume, Y. Reduced Port Thoracoscopic Surgery for Mediastinal and Pleural Disease: Experiences in a Single Institution. Indian J Surg 78, 173–176 (2016). https://doi.org/10.1007/s12262-015-1333-5
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DOI: https://doi.org/10.1007/s12262-015-1333-5