Lobe-specific Unidirectional Stapling Strategy in Video-assisted Thoracic Surgery Lobectomy

Purpose: To evaluate the feasibility of the lobe-specific unidirectional stapling strategy (LSUS) strategy in video-assisted thoracic surgery (VATS) lobectomy. Methods: A retrospective analysis was conducted on 123 patients, who underwent VATS lobectomy using LSUS. The vein, artery, and bronchus of each lobe were stapled through a lobe-specific port. The posteroinferior port, in the eighth intercostal space on the posterior axillary line, was the stapler port in upper or middle lobectomies. The anteroinferior port, in the sixth intercostal space on the anterior axillary line, was used for each lower lobectomy. Results: VATS lobectomy was completed in 116 (94%) patients and LSUS was successful for every lobectomy in these patients. There were no adverse events related to stapling. Fifteen patients experienced postoperative complications. The operative mortality rate was 1.7%. The mean pain score on the first postoperative day was 3.2 out of 10. Conclusions: LSUS is feasible and safe for all type of VATS lobectomy.