Single-port video-assisted thoracoscopic surgery subsegmentectomy: The learning curve and initial outcome

研究成果: Article

摘要

Background: We report initial surgical results and learning process of single-port video-assisted thoracoscopic surgery (VATS) subsegmentectomy in comparison with segmentectomy in our institution as the presentative of minimal invasiveness and precise resection for early stage lung cancer. Methods: All patients undergoing single-port VATS sublobar anatomic resection between January 2014 and December 2018 for clinical diagnosis of lung cancer were included. The learning curve was analyzed using the cumulative summation (CUSUM) method. Comparisons were done between those who underwent single-port VATS subsegmentectomy and segmentectomy. Results: A total of 364 patients underwent single-port VATS segmentectomy and 91 patients underwent single-port VATS subsegmentectomy were included. Lung adenocarcinoma was the most common (61.1%) diagnosis. The operative time and blood loss in the subsegmentectomy group were less than the segmentectomy group. The incidence of intraoperative complication was also lower in the subsegmentectomy group. The surgical proficiency was reached at 28 cases in single-port VATS subsegmentectomy. For primary lung cancer, the tumor size in subsegmentectomy group was smaller than segmentectomy group (1.1 cm versus 1.4 cm, p = 0.026). The resection margin was smaller in subsegmentectomy group, and both groups reached adequate margin without significant difference (94.7% versus 95.5%, p = 0.737). During the follow-up period, 2 (3.5%) patients in subsegmentectomy group and 9 (4.1%) patients in segmentectomy group developed distant metastasis. Conclusion: Single-port VATS subsegmentectomy is safe and feasible for small-sized lung lesion, providing the benefit of minimal invasiveness, preservation of pulmonary function, and clearance of lymphatic drainage at the intersegmental plane. The surgical proficiency could be achieved based on the experiences in single-port VATS segmentectomy.

原文English
期刊Asian Journal of Surgery
DOIs
出版狀態Accepted/In press - 2019 一月 1

指紋

Video-Assisted Thoracic Surgery
Learning Curve
Segmental Mastectomy
Lung Neoplasms
Lung
Intraoperative Complications
Operative Time
Drainage
Learning
Neoplasm Metastasis
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

引用此文

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title = "Single-port video-assisted thoracoscopic surgery subsegmentectomy: The learning curve and initial outcome",
abstract = "Background: We report initial surgical results and learning process of single-port video-assisted thoracoscopic surgery (VATS) subsegmentectomy in comparison with segmentectomy in our institution as the presentative of minimal invasiveness and precise resection for early stage lung cancer. Methods: All patients undergoing single-port VATS sublobar anatomic resection between January 2014 and December 2018 for clinical diagnosis of lung cancer were included. The learning curve was analyzed using the cumulative summation (CUSUM) method. Comparisons were done between those who underwent single-port VATS subsegmentectomy and segmentectomy. Results: A total of 364 patients underwent single-port VATS segmentectomy and 91 patients underwent single-port VATS subsegmentectomy were included. Lung adenocarcinoma was the most common (61.1{\%}) diagnosis. The operative time and blood loss in the subsegmentectomy group were less than the segmentectomy group. The incidence of intraoperative complication was also lower in the subsegmentectomy group. The surgical proficiency was reached at 28 cases in single-port VATS subsegmentectomy. For primary lung cancer, the tumor size in subsegmentectomy group was smaller than segmentectomy group (1.1 cm versus 1.4 cm, p = 0.026). The resection margin was smaller in subsegmentectomy group, and both groups reached adequate margin without significant difference (94.7{\%} versus 95.5{\%}, p = 0.737). During the follow-up period, 2 (3.5{\%}) patients in subsegmentectomy group and 9 (4.1{\%}) patients in segmentectomy group developed distant metastasis. Conclusion: Single-port VATS subsegmentectomy is safe and feasible for small-sized lung lesion, providing the benefit of minimal invasiveness, preservation of pulmonary function, and clearance of lymphatic drainage at the intersegmental plane. The surgical proficiency could be achieved based on the experiences in single-port VATS segmentectomy.",
author = "Chang, {Chao Chun} and Yen, {Yi Ting} and Lin, {Chia Ying} and Chen, {Ying Yuan} and Huang, {Wei Li} and Tseng, {Yau Lin}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.asjsur.2019.09.009",
language = "English",
journal = "Asian Journal of Surgery",
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TY - JOUR

T1 - Single-port video-assisted thoracoscopic surgery subsegmentectomy

T2 - The learning curve and initial outcome

AU - Chang, Chao Chun

AU - Yen, Yi Ting

AU - Lin, Chia Ying

AU - Chen, Ying Yuan

AU - Huang, Wei Li

AU - Tseng, Yau Lin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: We report initial surgical results and learning process of single-port video-assisted thoracoscopic surgery (VATS) subsegmentectomy in comparison with segmentectomy in our institution as the presentative of minimal invasiveness and precise resection for early stage lung cancer. Methods: All patients undergoing single-port VATS sublobar anatomic resection between January 2014 and December 2018 for clinical diagnosis of lung cancer were included. The learning curve was analyzed using the cumulative summation (CUSUM) method. Comparisons were done between those who underwent single-port VATS subsegmentectomy and segmentectomy. Results: A total of 364 patients underwent single-port VATS segmentectomy and 91 patients underwent single-port VATS subsegmentectomy were included. Lung adenocarcinoma was the most common (61.1%) diagnosis. The operative time and blood loss in the subsegmentectomy group were less than the segmentectomy group. The incidence of intraoperative complication was also lower in the subsegmentectomy group. The surgical proficiency was reached at 28 cases in single-port VATS subsegmentectomy. For primary lung cancer, the tumor size in subsegmentectomy group was smaller than segmentectomy group (1.1 cm versus 1.4 cm, p = 0.026). The resection margin was smaller in subsegmentectomy group, and both groups reached adequate margin without significant difference (94.7% versus 95.5%, p = 0.737). During the follow-up period, 2 (3.5%) patients in subsegmentectomy group and 9 (4.1%) patients in segmentectomy group developed distant metastasis. Conclusion: Single-port VATS subsegmentectomy is safe and feasible for small-sized lung lesion, providing the benefit of minimal invasiveness, preservation of pulmonary function, and clearance of lymphatic drainage at the intersegmental plane. The surgical proficiency could be achieved based on the experiences in single-port VATS segmentectomy.

AB - Background: We report initial surgical results and learning process of single-port video-assisted thoracoscopic surgery (VATS) subsegmentectomy in comparison with segmentectomy in our institution as the presentative of minimal invasiveness and precise resection for early stage lung cancer. Methods: All patients undergoing single-port VATS sublobar anatomic resection between January 2014 and December 2018 for clinical diagnosis of lung cancer were included. The learning curve was analyzed using the cumulative summation (CUSUM) method. Comparisons were done between those who underwent single-port VATS subsegmentectomy and segmentectomy. Results: A total of 364 patients underwent single-port VATS segmentectomy and 91 patients underwent single-port VATS subsegmentectomy were included. Lung adenocarcinoma was the most common (61.1%) diagnosis. The operative time and blood loss in the subsegmentectomy group were less than the segmentectomy group. The incidence of intraoperative complication was also lower in the subsegmentectomy group. The surgical proficiency was reached at 28 cases in single-port VATS subsegmentectomy. For primary lung cancer, the tumor size in subsegmentectomy group was smaller than segmentectomy group (1.1 cm versus 1.4 cm, p = 0.026). The resection margin was smaller in subsegmentectomy group, and both groups reached adequate margin without significant difference (94.7% versus 95.5%, p = 0.737). During the follow-up period, 2 (3.5%) patients in subsegmentectomy group and 9 (4.1%) patients in segmentectomy group developed distant metastasis. Conclusion: Single-port VATS subsegmentectomy is safe and feasible for small-sized lung lesion, providing the benefit of minimal invasiveness, preservation of pulmonary function, and clearance of lymphatic drainage at the intersegmental plane. The surgical proficiency could be achieved based on the experiences in single-port VATS segmentectomy.

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DO - 10.1016/j.asjsur.2019.09.009

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SN - 1015-9584

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