Simultaneously thoracoscopic resection of lung cancer and anterior mediastinal lesions by video-assisted thoracoscopic surgery.

Background Video-assisted thoracoscopic surgery (VATS) has been widely applied to various types of pulmonary and mediastinal resections in recent years. However, there are still limited experiences of simultaneous thoracoscopic resection for lung cancer and mediastinal tumor. The aim of the study is to investigate the technical safety and feasibility of uniportal VATS for simultaneous resection for concurrent diseases of lung and anterior mediastinum and to compare with multiportal VATS. Methods From June 2014 to December 2017, all patients who underwent simultaneously thoracoscopic resection for lung cancer and anterior mediastinal mass under uniportal or multiportal VATS via the same incision were retrospectively reviewed. Study cohort was divided according to surgical approach. Perioperative outcomes, including operative time, intraoperative blood loss, and postoperative hospitalization, were compared between uniportal and multiportal VATS groups. Results A total of 51 patients were included in the study, of whom 33 patients had uniportal VATS and 18 patients had multiportal VATS. When compared to multiportal VATS group, uniportal VATS group had similar time of operation (149.1±49.0 vs. 159.1±58.5, P=0.518), intraoperative blood loss (103.0±184.3 vs. 105.6±80.2, P=0.956), and postoperative length of hospital stay (4.7±2.0 vs. 5.5±3.0, P=0.246). No operative deaths occurred in this study. Conclusions Uniportal VATS for simultaneously thoracoscopic resection for lung cancer and anterior mediastinal disease is technically safe and feasible and has comparable operative parameters with multiportal VATS.

[1]  G. Jiang,et al.  One hundred and fifty-six cases of anatomical pulmonary segmentectomy by uniportal video-assisted thoracic surgery: a 2-year learning experience , 2018, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[2]  J. Roth,et al.  Comparison of outcomes between muscle-sparing thoracotomy and video-assisted thoracic surgery in patients with cT1 N0 M0 lung cancer. , 2018, The Journal of thoracic and cardiovascular surgery.

[3]  Kaitlin M. Woo,et al.  Long-term Survival Based on the Surgical Approach to Lobectomy For Clinical Stage I Nonsmall Cell Lung Cancer: Comparison of Robotic, Video-assisted Thoracic Surgery, and Thoracotomy Lobectomy , 2017, Annals of surgery.

[4]  Hai-bo Shen,et al.  Minimally invasive resection of synchronous triple primary tumors of the esophagus, lung, and thymus: A case report , 2016, International journal of surgery case reports.

[5]  P. Licht,et al.  Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. , 2016, The Lancet. Oncology.

[6]  Ching-Yang Wu,et al.  Single port VATS mediastinal tumor resection: Taiwan experience. , 2016, Annals of cardiothoracic surgery.

[7]  J. Crowley,et al.  The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer , 2016, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[8]  W. Scott,et al.  Minimally Invasive versus Open Thymectomy for Thymic Malignancies: Systematic Review and Meta‐Analysis , 2016, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[9]  Y. Chao,et al.  Single-port video-assisted thoracoscopic mediastinal tumour resection. , 2015, Interactive cardiovascular and thoracic surgery.

[10]  M. Hsieh,et al.  Comparative Short-Term Clinical Outcomes of Mediastinum Tumor Excision Performed by Conventional VATS and Single-Port VATS , 2015, Medicine.

[11]  Lunxu Liu,et al.  Simultaneous thoracoscopic resection for coexisting pulmonary and thymic lesions. , 2015, Journal of thoracic disease.

[12]  Chia-Chuan Liu,et al.  Single-incision versus multiple-incision thoracoscopic lobectomy and segmentectomy: a propensity-matched analysis. , 2015, Annals of surgery.

[13]  E. Garelli,et al.  Long-Term Outcome for Early Stage Thymoma: Comparison between Thoracoscopic and Open Approaches , 2015, Thoracic and Cardiovascular Surgeon.

[14]  Andrzej S. Kosinski,et al.  Fewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer. , 2014, The Journal of thoracic and cardiovascular surgery.

[15]  G. Jiang,et al.  Simultaneous video-assisted thoracoscopic surgery sleeve lobectomy and thymectomy. , 2014, Interactive cardiovascular and thoracic surgery.

[16]  Jianxin Shi,et al.  Surgical techniques for early-stage thymoma: video-assisted thoracoscopic thymectomy versus transsternal thymectomy. , 2014, The Journal of thoracic and cardiovascular surgery.

[17]  D. González-Rivas,et al.  Uniportal video-assisted thoracoscopic bronchial sleeve lobectomy: first report. , 2013, The Journal of thoracic and cardiovascular surgery.

[18]  D. González-Rivas,et al.  Uniportal video-assisted thoracoscopic lobectomy: two years of experience. , 2013, The Annals of thoracic surgery.

[19]  D. González-Rivas,et al.  Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. , 2012, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[20]  D. González-Rivas,et al.  Single-incision video-assisted thoracoscopic right pneumonectomy , 2012, Surgical Endoscopy.

[21]  J. Luketich,et al.  Comparison of surgical techniques for early-stage thymoma: feasibility of minimally invasive thymectomy and comparison with open resection. , 2011, The Journal of thoracic and cardiovascular surgery.

[22]  M. Paradela,et al.  Single-port video-assisted thoracoscopic lobectomy. , 2011, Interactive cardiovascular and thoracic surgery.

[23]  B. Meyers,et al.  Video-assisted thoracic surgery versus open lobectomy for lung cancer: a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. , 2010, The Journal of thoracic and cardiovascular surgery.

[24]  F. Venuta,et al.  Thoracoscopic resection of mediastinal bronchogenic cysts in adults. , 2009, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[25]  Tristan D Yan,et al.  Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[26]  D. Sugarbaker,et al.  Video-assisted thoracic surgery lobectomy: report of CALGB 39802--a prospective, multi-institution feasibility study. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  R. Mckenna,et al.  Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. , 2006, The Annals of thoracic surgery.

[28]  Gaetano Rocco,et al.  Uniportal VATS wedge pulmonary resections. , 2004, The Annals of thoracic surgery.

[29]  A. Yim Video-assisted thoracoscopic resection of anterior mediastinal masses. , 1996, International surgery.

[30]  A. Sihoe,et al.  Short-term outcomes of single- versus multi-port video-assisted thoracic surgery in mediastinal diseases , 2018, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[31]  G. Jiang,et al.  Single-port video-assisted thoracic surgery in 1063 cases: a single-institution experience†. , 2016, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[32]  F. Stella,et al.  Synchronous thymoma and lung adenocarcinoma treated with a single mini-invasive approach. , 2015, Heart, lung & circulation.

[33]  Mong-Wei Lin,et al.  Video-Assisted Thoracoscopic Surgical Thymectomy to Treat Early Thymoma: A Comparison with the Conventional Transsternal Approach , 2013, Annals of Surgical Oncology.

[34]  F. Venuta,et al.  Synchronous B3 thymoma and lung bronchoalveolar carcinoma. , 2011, Interactive cardiovascular and thoracic surgery.