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Needlescopic-assisted thoracoscopic pulmonary anatomical lobectomy and segmentectomy for lung cancer: a bridge between multiportal and uniportal thoracoscopic surgery

Surgery Today volume 49, pages 49–55 (2019)Cite this article

Abstract

Purpose

Needlescopic instruments allow us to perform complex laparoscopic procedures, which are almost painless and scarless postoperatively; however, their utilization in thoracoscopic surgery has been limited to minor procedures, including bullectomy and sympathectomy. We present our initial experience of performing thoracoscopic anatomical lung resection via a single utility incision with additional needlescopic working ports and compare the operative results with those of uniportal video-assisted thorascopic surgery (VATS).

Methods

We reviewed data on 75 consecutive patients with lung cancer, who underwent anatomical lung resections, including lobectomy and segmentectomy, between February 2015 and September 2017. Of the 75 patients, 39 underwent uniportal VATS (uniportal group), and 36 underwent needlescopic-assisted VATS (n-VATS group). We compared the peri- and postoperative outcomes of the two groups.

Results

The clinical characteristics did not differ significantly between the groups, except in the ages of the patients. The n-VATS group had a shorter operation time (mean 159.3 min vs. 198.8 min, P = 0.023) and lower intraoperative blood loss (mean 40.9 mL vs. 143.2 mL, P = 0.047). Two major pulmonary arterial bleeding events and one conversion to thoracotomy occurred in the uniportal group.

Conclusion

Uniportal VATS can be performed more efficiently and safely with the assistance of additional needlescopic ports and instruments, without compromising the benefits of less postoperative pain and early recovery.

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Acknowledgements

We thank the staff of Biotechnology R&D Center, National Taiwan University Hospital, Hsin-Chu Branch for their assistance with the study design and statistical analysis.

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Affiliations

  1. Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan

    Huan-Jang Ko, Shun-Mao Yang & Ming-Chi Yang

  2. Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Xu-Heng Chiang & Shun-Mao Yang

Authors
  1. Huan-Jang Ko
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  2. Xu-Heng Chiang
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Correspondence to Shun-Mao Yang.

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Drs. Huan-Jang Ko, Xu-Heng Chiang, Shun-Mao Yang, and Ming-Chi Yang have no conflicts of interest or financial ties to disclose.

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Ko, HJ., Chiang, XH., Yang, SM. et al. Needlescopic-assisted thoracoscopic pulmonary anatomical lobectomy and segmentectomy for lung cancer: a bridge between multiportal and uniportal thoracoscopic surgery. Surg Today 49, 49–55 (2019). https://doi.org/10.1007/s00595-018-1707-y

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Keywords

  • Needlescopic
  • Uniportal
  • Anatomical resection
  • Lung cancer