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. 2018 Nov;10(Suppl 31):S3678-S3685.
doi: 10.21037/jtd.2018.03.119.

Uniportal video-assisted thoracic surgery Roman experience-a report of the first 16-month Roman experience

Dania Nachira  1 , Elisa Meacci  1 , Leonardo Petracca Ciavarella  1 , Marco Chiappetta  1 , Giulia De Santis  1 , Gian Maria Ferretti  1 , Maria Giovanna Mastromarino  1 , Venanzio Porziella  1 , Maria Letizia Vita  1 , Maria Teresa Congedo  1 , Alfredo Cesario  1 , Mahmoud Ismail  2 , Diego Gonzalez-Rivas  3   4 , Stefano Margaritora  1
Affiliations

Uniportal video-assisted thoracic surgery Roman experience-a report of the first 16-month Roman experience

Dania Nachira et al. J Thorac Dis. 2018 Nov.

Abstract

Background: The acceptance of uniportal video-assisted thoracic surgery (U-VATS) for thoracic procedures has been growing worldwide. This study reports one of the widest Italian U-VATS experiences.

Methods: The prospectively collected data of 237 patients underwent a U-VATS procedure, between May 2016 and September 2017, were retrospectively reviewed. A wide range of procedures, like major and minor lung resections, esophageal surgery, pleural and mediastinal one, was performed. The main aim of the study was evaluating general outcomes in terms of safety and effectiveness, and analyzing short-term results of U-VATS approach.

Results: The mean age of population was 59.93±16.03 years. In 208 cases (85.3%) a U-VATS lung resection was performed, in 10 cases (4.1%) an esophagectomy or an esophageal diverticulectomy, in 15 (6.1%) a mediastinal procedure and in 11 (4.5%) a toilette for pleural empyema or removal of pleural lesions. The chest tube duration was 4.24±3.73 days and the postoperative hospital stay was 4.62±4.59 days. The intraoperative and thirty-day mortality were null. Mean level of pain in I postoperative day was 2.30±1.26 on VAS scale and the mean duration was of 1.54±1.21 days. In 93% of cases there was a resolution of pain after chest tube removal. Furthermore, the average level of cosmetic satisfaction was 2.73±0.49 (measured on a 0-3 scale).

Conclusions: According to our experience, U-VATS seems to be a safe and practicable mini-invasive technique, above all for surgeons who already have thoracoscopy experience or made proper training attending multilevel courses, hands-on conferences and wet-labs.

Keywords: Uniportal video-assisted thoracic surgery (U-VATS); lung cancer; lung major resections; mediastinal surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Position of the patient, of the surgical equipe and scrub nurse during U-VATS procedure. U-VATS, uniportal video-assisted thoracic surgery.
Figure 2
Figure 2
Intercostal nerve blockage under endoscopic view.
Figure 3
Figure 3
Position of the chest tube in the U-VATS incision. U-VATS, uniportal video-assisted thoracic surgery.
Figure 4
Figure 4
Trend of U-VATS procedures during our 16-month experience. U-VATS, uniportal video-assisted thoracic surgery.
Figure 5
Figure 5
Postoperative pain level (A) and cosmetic results (B).
See this image and copyright information in PMC

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