Korean Journal of Thoracic and Cardiovascular Surgery 2017; 50(5): 339-345  https://doi.org/10.5090/kjtcs.2017.50.5.339
Efficacy of Single-Port Video-Assisted Thoracoscopic Surgery Lobectomy Compared with Triple-Port VATS by Propensity Score Matching
Kyung Sub Song, M.D., Chang Kwon Park, M.D., Jae Bum Kim, M.D.
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine
Chang Kwon Park
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea
(Tel) 82-53-250-7307 (Fax) 82-53-250-7307 (E-mail) ckpark80@dsmc.or.kr
Received: December 12, 2016; Revised: January 31, 2017; Accepted: March 29, 2017.; Published online: October 5, 2017.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

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Abstract
Background: In recent years, single-port video-assisted thoracoscopic surgery (VATS) for lobectomy in non-small cell lung cancer (NSCLC) patients has become increasingly common. The objective of this study was to compare the feasibility and safety of single-port and triple-port VATS lobectomy. Methods: A total of 73 patients with NSCLC who underwent VATS lobectomy from December 2011 to August 2016 were retrospectively reviewed, including 47 in the triple-port group and 26 in the single-port group. Statistical analysis was performed after propensity score matching. Patients were matched on a 1-to-1 basis. Results: Operative time and intraoperative blood loss in the triple-port group and the single-port group were similar (189.4±50.8 minutes vs. 205.4±50.6 minutes, p=0.259; 286.5±531.0 mL vs. 314.6±513.1 mL, p=0.813). There were no cases of morbidity or mortality. No significant differences in complications or the total number of dissected lymph nodes were found between the 2 groups. In the single-port group, more mediastinal lymph nodes were dissected than in the triple-port group (1.7±0.6 vs. 1.2±0.5, p=0.011). Both groups had 1 patient with bronchopleural fistula. Chest tube duration and postoperative hospital stay were shorter in the single- port group than in the triple-port group (8.7±5.1 days vs. 6.2±6.6 days, p=0.130; 11.7±6.1 days vs. 9.5±6.4 days, p=0.226). However, the differences were not statistically significant. In the single-port group, the rate of conversion to multi-port VATS lobectomy was 11.5% (3 of 26). The rates of conversion to open thoracotomy in the triple-port and single-port groups were 7.7% and 3.8%, respectively (p=1.000). Conclusion: In comparison with the triple-port group, single-port VATS lobectomy showed similar results in safety and efficacy, indicating that single-port VATS lobectomy is a feasible and safe option for lung cancer patients.
Keywords: Video-assisted thoracic surgery, Lobectomy, Lung neoplasms


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