Single-Port Video-Assisted Thoracoscopic Major Lung Resections: Experience with 150 Consecutive Cases

Calvin S H Ng, Hyun Koo Kim, Randolph H L Wong, Anthony P C Yim, Tony S K Mok, Young Ho Choi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background Video-assisted thoracic surgery (VATS) for major lung resection has undergone major changes from three or four-port approach to the recently possible single-port VATS approach. Outcomes following single-port VATS major lung resection are analyzed to determine safety and efficacy. Methods A prospective database of 150 consecutive patients who underwent single-port VATS major lung resection between March 2012 and January 2014 was reviewed. Patient demographics, perioperative parameters, histopathology, and outcomes up to follow-up of 2 years were analyzed by descriptive and Kaplan-Meier survival statistics. Results Single-port VATS major lung resection was successfully performed in 142 patients (conversion rate 5.3%) for both malignant and benign diseases of the lung. Overall, 130 patients (87%) had nonsmall-cell lung carcinoma (NSCLC), 9 (6%) had other types of primary lung cancer, and the remaining for secondary malignancies and benign diseases. Among the 130 patients with NSCLC, 93 (71.5%) were stage I, 28 were stage II (21.5%), and 9 (7%) were stage III or greater. There was no intraoperative or 30-day mortality. However, one perioperative death occurred on day 49, and another on day 60 postoperatively due to infective causes. The overall 2-year mortality rate for all patients was 3%. The disease-free survival rate for subgroups, stage I NSCLC, and stage II or greater NSCLC were 96 and 83%, respectively. Conclusions Single-port VATS major lung resection for malignant and benign lung diseases is associated with low perioperative morbidity and mortality. Disease-free survival rates for NSCLC are acceptable and comparable with conventional VATS.

Original languageEnglish
Pages (from-to)348-353
Number of pages6
JournalThoracic and Cardiovascular Surgeon
Volume64
Issue number4
DOIs
Publication statusPublished - 2015 Jan 20

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Video-Assisted Thoracic Surgery
Lung
Carcinoma
Lung Diseases
Disease-Free Survival
Mortality
Survival Rate
Lung Neoplasms
Demography
Databases
Morbidity
Safety
Survival

Keywords

  • lung cancer
  • surgery
  • thoracoscopy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Single-Port Video-Assisted Thoracoscopic Major Lung Resections : Experience with 150 Consecutive Cases. / Ng, Calvin S H; Kim, Hyun Koo ; Wong, Randolph H L; Yim, Anthony P C; Mok, Tony S K; Choi, Young Ho.

In: Thoracic and Cardiovascular Surgeon, Vol. 64, No. 4, 20.01.2015, p. 348-353.

Research output: Contribution to journalArticle

Ng, Calvin S H ; Kim, Hyun Koo ; Wong, Randolph H L ; Yim, Anthony P C ; Mok, Tony S K ; Choi, Young Ho. / Single-Port Video-Assisted Thoracoscopic Major Lung Resections : Experience with 150 Consecutive Cases. In: Thoracic and Cardiovascular Surgeon. 2015 ; Vol. 64, No. 4. pp. 348-353.
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abstract = "Background Video-assisted thoracic surgery (VATS) for major lung resection has undergone major changes from three or four-port approach to the recently possible single-port VATS approach. Outcomes following single-port VATS major lung resection are analyzed to determine safety and efficacy. Methods A prospective database of 150 consecutive patients who underwent single-port VATS major lung resection between March 2012 and January 2014 was reviewed. Patient demographics, perioperative parameters, histopathology, and outcomes up to follow-up of 2 years were analyzed by descriptive and Kaplan-Meier survival statistics. Results Single-port VATS major lung resection was successfully performed in 142 patients (conversion rate 5.3{\%}) for both malignant and benign diseases of the lung. Overall, 130 patients (87{\%}) had nonsmall-cell lung carcinoma (NSCLC), 9 (6{\%}) had other types of primary lung cancer, and the remaining for secondary malignancies and benign diseases. Among the 130 patients with NSCLC, 93 (71.5{\%}) were stage I, 28 were stage II (21.5{\%}), and 9 (7{\%}) were stage III or greater. There was no intraoperative or 30-day mortality. However, one perioperative death occurred on day 49, and another on day 60 postoperatively due to infective causes. The overall 2-year mortality rate for all patients was 3{\%}. The disease-free survival rate for subgroups, stage I NSCLC, and stage II or greater NSCLC were 96 and 83{\%}, respectively. Conclusions Single-port VATS major lung resection for malignant and benign lung diseases is associated with low perioperative morbidity and mortality. Disease-free survival rates for NSCLC are acceptable and comparable with conventional VATS.",
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