Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database

被引：17

作者：

Tosi, Davide ^{[1
]}

Nosotti, Mario ^{[1
]}

Bonitta, Gianluca ^{[1
]}

Mazzucco, Alessandra ^{[1
]}

Righi, Ilaria ^{[1
]}

Mendogni, Paolo ^{[1
]}

Rosso, Lorenzo ^{[1
]}

Palleschi, Alessandro ^{[1
]}

Rocco, Gaetano ^{[2
]}

Crisci, Roberto ^{[3
]}

Mancuso, M. ^{[4
]}

Pernazza, F. ^{[4
]}

Refai, M. ^{[5
]}

Bortolotti, L. ^{[6
]}

Rizzardi, G. ^{[6
]}

Gargiulo, G. ^{[7
]}

Dolci, G. P. ^{[7
]}

Perkmann, R. ^{[8
]}

Zaraca, F. ^{[8
]}

Benvenuti, M. ^{[9
]}

Gavezzoli, D. ^{[9
]}

Cherchi, R. ^{[10
]}

Ferrari, P. ^{[10
]}

Mucilli, F. ^{[11
]}

Camplese, P. ^{[11
]}

Melloni, G. ^{[12
]}

Mazza, F. ^{[12
]}

Cavallesco, G. ^{[13
]}

Maniscalco, P. ^{[13
]}

Voltolini, L. ^{[14
]}

Gonfiotti, A. ^{[14
]}

Stella, F. ^{[15
]}

Argnani, D. ^{[15
]}

Pariscenti, G. L. ^{[16
]}

Lurilli ^{[16
]}

Surrente, C. ^{[17
]}

Lopez, C. ^{[17
]}

Droghetti, A. ^{[18
]}

Giovanardi, M. ^{[18
]}

Breda, C. ^{[19
]}

Lo Giudice, F. ^{[19
]}

Alloisio, M. ^{[20
]}

Bottoni, E. ^{[20
]}

Spaggiari, L. ^{[21
]}

Gasparri, R. ^{[21
]}

Torre, M. ^{[22
]}

Rinaldo, A. ^{[22
]}

Nosotti, M. ^{[23
]}

Rosso, L. ^{[23
]}

Negri, G. P. ^{[24
]}

机构：

[1] Fdn Irccs Ca Granda Osped Maggiore Policlin, Thorac Surg & Lung Transplant Unit, Via Francesco Sforza 35, I-20122 Milan, Italy

[2] Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Serv, 1275 York Ave, New York, NY 10021 USA

[3] Univ Aquila, G Mazzini Hosp, Thorac Surg Unit, Teramo, Italy

[4] Alessandria Hosp, Alessandria, Italy

[5] Ancona Hosp, Salesi, Italy

[6] Humanitas Gavazzeni, Bergamo, Italy

[7] St Orsola Hosp, Bologna, Italy

[8] Bolzano Hosp, Bolzano, Italy

[9] Brescia Hosp, Brescia, Italy

[10] Brotzu Hosp, Cagliari, Italy

[11] S Maria Annunziata Hosp, Chieti, Italy

[12] Cuneo Hosp, Cuneo, Italy

[13] Ferrara Univ Hosp, Ferrara, Italy

[14] Careggi Hosp, Florence, Italy

[15] Morgagni Hosp, Forli, Italy

[16] San Martino Hosp, Genoa, Italy

[17] Fazzi Hosp, Lecce, Italy

[18] C Poma Hosp, Mantua, Italy

[19] Mestre Hosp, Venice, Italy

[20] IRCCS Humanitas, Milan, Italy

[21] IEO Hosp, Milan, Italy

[22] Osped Niguarda Ca Granda, Milan, Italy

[23] Fdn IRCCS Ca Granda, Milan, Italy

[24] S Raffaele Hosp, Milan, Italy

[25] Modena Hosp, Modena, Italy

[26] S Gerardo Hosp, Monza, Italy

[27] Monaldi Hosp, Naples, Italy

[28] Maggiore Carita Hosp, Novara, Italy

[29] Univ Hosp Padova, Padua, Italy

[30] IRCCS ISMETT, Palermo, Italy

[31] Univ Hosp, Parma, Italy

[32] Univ Hosp, Perugia, Italy

[33] S Andrea Hosp, Rome, Italy

[34] Forlanini Hosp, Rome, Italy

[35] Gemelli Hosp, Rome, Italy

[36] Univ Hosp, Siena, Italy

[37] Mazzini Hosp, Teramo, Italy

[38] Molinette Mauriziano Hosp, Turin, Italy

[39] S Giovanni Bosco Hosp, Turin, Italy

[40] Osped S Maria Misericordia, Udine, Italy

[41] Varese Hosp, Varese, Italy

[42] Negrar Hosp, Verona, Italy

[43] Borgo Trento City Hosp, Verona, Italy

来源：

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY | 2019年 / 29卷 / 05期

关键词：

Video-assisted thoracic surgery; Lobectomy; Uniportal; Three-portal; Postoperative pain; Italian VATS Group; THORACOSCOPIC LOBECTOMY; SINGLE-INCISION; PORT; PAIN;

D O I：

10.1093/icvts/ivz153

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES: This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of dissected lymph nodes and length of stay. METHODS: This was an observational, retrospective, cohort, multicentre study on data collected by 49 Italian thoracic units. Inclusion criteria were clinical stage I-II non-small-cell lung cancer, uniportal or 3-portal VATS lobectomy and R0 resection. Exclusion criteria were cT3 disease, previous thoracic malignancy, induction therapy, significant comorbidities and conversion to other techniques. The pain parameter was dichotomized: the numeric rating scale <= 3 described mild pain, whereas the numeric rating scale score >3 described moderate/severe pain. The propensity score-adjusted generalized estimating equation was used to compare the uniportal with 3-portal lobectomy. RESULTS: Among 4338 patients enrolled from January 2014 to July 2017, 1980 met the inclusion criteria; 1808 patients underwent 3-portal lobectomy and 172 uniportal surgery. The adjusted generalized estimating equation regression model using the propensity score showed that over time pain decreased in both groups (P<0.001). There was a statistical difference on the second and third postoperative days; odds ratio (OR) 2.28 [95% confidence interval (CI) 1.62-3.21; P<0.001] and OR 2.58 (95% CI 1.74-3.83; P<0.001), respectively. The uniportal-VATS group had higher operative time (P<0.001), shorter chest drain permanence (P<0.001) and shorter length of stay (P<0.001). CONCLUSIONS: Data from the Italian VATS Group Database showed that in clinical practice uniportal lobectomy seems to entail a higher risk of moderate/severe pain on second and third postoperative days.

引用

页码：714 / 721

页数：8

共 50 条

[1] Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database (vol 29, pg 714, 2019)
Tosi, Davide
Nosotti, Mario
Bonitta, Gianluca
Mazzucco, Alessandra
Righi, Ilaria
Mendogni, Paolo
Rosso, Lorenzo
Palleschi, Alessandro
Rocco, Gaetano
Crisci, Roberto
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2019, 29 (05) : 821 - 821
[2] Uniportal Video-Assisted Thoracic Surgery Esophagectomy
Dmitrii, Sekhniaidze
Pavel, Kononets
THORACIC SURGERY CLINICS, 2017, 27 (04) : 407 - +
[3] Uniportal video-assisted thoracic surgery thymectomy
Scarci, Marco
Pardolesi, Alessandro
Solli, Piergiorgio
ANNALS OF CARDIOTHORACIC SURGERY, 2015, 4 (06) : 567 - 570
[4] Are There Contraindications for Uniportal Video-Assisted Thoracic Surgery?
Sihoe, Alan D. L.
THORACIC SURGERY CLINICS, 2017, 27 (04) : 373 - +
[5] Uniportal video-assisted thoracic surgery Preface
Gonzalez-Rivas, Diego
ANNALS OF CARDIOTHORACIC SURGERY, 2016, 5 (02) : 75 - 75
[6] Training in Uniportal Video-Assisted Thoracic Surgery
Sandri, Alberto
Sihoe, Alan D. L.
Salati, Michele
Gonzalez-Rivas, Diego
Brunelli, Alessandro
THORACIC SURGERY CLINICS, 2017, 27 (04) : 417 - +
[7] Transition from multiportal video-assisted thoracic surgery to uniportal video-assisted thoracic surgery... and evolution to uniportal robotic-assisted thoracic surgery?
Sihoe, Alan D. L.
ANNALS OF CARDIOTHORACIC SURGERY, 2023, 12 (02) : 82 - 90
[8] Uniportal approach as an alternative to the three-portal approach to video-assisted thoracic surgery for primary spontaneous pneumothorax
Yoshikawa, Ryohei
Matsuura, Natsumi
Igai, Hitoshi
Yazawa, Tomohiro
Ohsawa, Fumi
Kamiyoshihara, Mitsuhiro
JOURNAL OF THORACIC DISEASE, 2021, 13 (02) : 927 - 934
[9] Troubleshooting video-assisted thoracic surgery lobectomy
Demmy, TL
James, TA
Swanson, SJ
McKenna, RJ
D'Amico, TA
ANNALS OF THORACIC SURGERY, 2005, 79 (05): : 1744 - 1753
[10] A brief history of uniportal video-assisted thoracic surgery
Vanstraelen, Stijn
Rocco, Gaetano
VIDEO-ASSISTED THORACIC SURGERY, 2023, 8

← 1 2 3 4 5 →