Abstract
Background
Uniportal video-assisted thoracic surgery is still a technical challenge, especially
anatomical segmentectomy for the lateral basal segment (S9), posterior basal segment
(S10), or both (S9+10). Different surgical procedures determine a variable pulmonary
functional reduction depending on the extent of the resection. This study aimed to
compare the efficiency of uniportal video-assisted thoracic surgery S9+10 segmentectomy
with video-assisted thoracic surgery basal segmentectomy in preserving pulmonary function.
Methods
The patients who had undergone single-port video-assisted thoracic surgery S9+10 segmentectomy
using a single-direction approach were age, sex, and pulmonary function matched with
those undergoing video-assisted thoracic surgery basal segmentectomy. The pulmonary
function tests were performed preoperatively, and at 3 and 6 months postoperatively.
The operative details, postoperative complications, and pulmonary function were statistically
analyzed.
Results
After matching, a total of 46 patients undergoing video-assisted thoracic surgery
S9+10 segmentectomy and 58 patients undergoing video-assisted thoracic surgery basal
segmentectomy were eligible for analysis. There was no significant difference in the
average blood loss, the duration of chest tube, intensive care unit stay, or hospital
stay between these 2 groups. There were no major postoperative complications and surgical
mortality was found in the 2 groups. The uniportal video-assisted thoracic surgery
S9+10 segmentectomy group had a greater preserved pulmonary function (concerning the
values of the forced vital capacity, forced expiratory volume in 1 second, forced
expiratory volume in 1 second %, and diffusion capacity of carbon monoxide %) than
video-assisted thoracic surgery basal segmentectomy group at 1 and 3 months postoperatively.
Conclusion
Uniportal video-assisted thoracic surgery anatomic S9+10 segmentectomy using a single-direction
approach was safe and feasible for early stages of nonsmall cell lung cancer, and
it offered significantly better functional preservation compared with basal segmentectomy.
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Article info
Publication history
Published online: August 28, 2022
Accepted:
May 30,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
