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Observational Study
. 2019 Nov 1;29(5):714-721.
doi: 10.1093/icvts/ivz153.

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

Davide Tosi  1 , Mario Nosotti  1 , Gianluca Bonitta  1 , Alessandra Mazzucco  1 , Ilaria Righi  1 , Paolo Mendogni  1 , Lorenzo Rosso  1 , Alessandro Palleschi  1 , Gaetano Rocco  2 , Roberto Crisci  3 ; Italian VATS Group
Collaborators, Affiliations
Observational Study

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

Davide Tosi et al. Interact Cardiovasc Thorac Surg. .

Erratum in

Abstract

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.

Keywords: Italian VATS Group; Lobectomy; Postoperative pain; Three-portal; Uniportal; Video-assisted thoracic surgery.

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Figures

Figure 1:
Figure 1:
Percentage of patients with moderate/severe pain. u-VATS: uniportal video-assisted thoracic surgery; VATS: video-assisted thoracic surgery.
None
See this image and copyright information in PMC

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