D. Gonzalez-Rivas, M. Delgado, E. Fieira, R. Fernandez, L. Mendez, M. D. l. Torre
2014 Interactive Cardiovascular and Thoracic Surgery  
Objectives: Uniportal video-assisted thoracic surgery (VATS) anatomic major pulmonary resections were initially described as an evolution from the conventional approach in our unit. Since then, many thoracic surgical departments have successfuly adopted this technique with good postoperative results. We report our experience with this minimally invasive technique for major pulmonary resections. Methods: In June 2010, we began performing VATS anatomic resections through a uniportal approach
more » ... ortal approach (non-rib spreading). By December 2013, 323 patients had undergone major pulmonary resections by this single-incision approach. We have included early stage tumours, advanced non-small-cell lung cancer (NSCLC) (bronchial sleeve or vascular reconstruction), complex pneumonectomies and lobectomies after chemo-radiotherapy induction treatment. Results: Of 323 attempted major resections, 312 were successfully completed by a single-incision approach (conversion rate 2.9%). We have analysed early outcomes of successful uniportal VATS major pulmonary resections. Right upper lobectomy was the most frequent procedure (25%). Mean surgical time was 139.2 ± 48 min (range 40-310 min), mean number of lymph nodes was 14.8 ± 7 (range 5-38 nodes) and mean number of explored stations was 4.7 ± 1.1 (range 3-8 stations) in NSCLC patients. The mean tumour size was 2.8 ± 1.5 cm (0-12). The median chest tube duration was 2 days and the median length of hospital stay was 3 days. There were complications in 60 patients and two patients died during the 60-day postoperative period. Conclusions: Single-incision VATS anatomical resection is a safe procedure with good perioperative results. The success in performing complex lobectomies through a single incision is a result of skills and experience accumulated over time from performing uniportal VATS surgery. Disclosure: No significant relationships. Interactive CardioVascular and Thoracic Surgery
doi:10.1093/icvts/ivu167.130 fatcat:v7rsfs2q5zatroq2lvfvmwp3hu