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Comparative Study
. 2025 May 21;25(1):220.
doi: 10.1186/s12893-025-02944-3.

Perioperative comparison of uniportal versus multiportal video-assisted thoracoscopic surgery for complex segmentectomy of the lower lung lobe

Xinyu Wang #  1 , Yuming Wang #  2 , Min Cao #  1 , Yujie Fu  1 , Wenbiao Pan  1 , Qing Ye  1 , Xiaojing Zhao  3 , Zhiyong Sun  4
Affiliations
Comparative Study

Perioperative comparison of uniportal versus multiportal video-assisted thoracoscopic surgery for complex segmentectomy of the lower lung lobe

Xinyu Wang et al. BMC Surg. .

Abstract

Background: Resection of basal segmentectomy through uniportal video-assisted thoracoscopic surgery (U-VATS) is technically challenging for thoracic surgeons. Compared with multiportal VATS (M-VATS), the safety and feasibility of U-VATS for complex segmentectomy of lower lung lobe need further validation. In this study, we aimed to compare the perioperative outcomes of U-VATS with M-VATS in the treatment of complex segmentectomy of lower lung lobe for stage IA lung cancer.

Methods: We conducted a retrospective cohort study of 168 patients (116 U-VATS and 52 M-VATS) undergoing complex lower lobe segmentectomy for stage IA NSCLC from January 2021 to May 2023. The demographics of the enrolled patients were collected and propensity score matching (PSM) was used to reduce the heterogeneity of baseline characteristics. Perioperative outcomes were compared between the two groups.

Results: After matching, 50 cases were yielded in each group. There was no 30-day postoperative mortality and conversion to open in both groups. The U-VATS exhibited shorter postoperative hospital stays (P = 0.034) and a trend toward reduced postoperative drainage (P = 0.081) compared to the M-VATS group. Pain score on postoperative day 2 in the U-VATS group was lower than M-VATS group (P = 0.004). There were no significant differences in resection margins, operation time and postoperative complications between the two groups.

Conclusions: U-VATS provides comparable perioperative safety and efficacy to M-VATS for complex lower lobe segmentectomy, with advantages in accelerated recovery and reduced postoperative pain. U-VATS complex segmentectomy of lower lung lobe is a safe and feasible technique for experienced thoracic surgeons, which deserves support and popularity.

Keywords: Complex segmentectomy; Lower lung lobe; Multiportal VATS; Uniportal VATS.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine and was performed in accordance with the Declaration of Helsinki. All methods were carried out in accordance with relevant guidelines and regulations. Prior written informed consent was obtained from all study participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Selection algorithm of the patients in this study
Fig. 2
Fig. 2
The incision configurations via U-VATS and M-VATS approaches
See this image and copyright information in PMC

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