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Cardiothoracic Surgery |

Early Outcomes Following Uniportal Video-Assisted Thoracic Surgery Lung Resection

Rainbow Lau, MBChB; Calvin Ng, MD; Micky Kwok, MBChB; Randolph Wong, MBChB; Eugene Yeung, MBBS; Innes Wan, MBChB; Song Wan, PhD; Malcolm Underwood, MD
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Prince of Wales Hospital, Hong Kong, Hong Kong


Chest. 2014;145(3_MeetingAbstracts):50A. doi:10.1378/chest.1794100
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Abstract

SESSION TITLE: Thoracic Surgery Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Advances in video-assisted thoracic surgery (VATS) techniques and associated technology have allowed the rapid development of uniportal VATS (UniVATS) lung resection in recent years. UniVATS may be associated with less access trauma and pain, quicker recovery and improved cosmesis. We review our experience and early outcomes for patients following UniVATS wedge resections (W), lobectomies (L) and pneumonectomy (P).

METHODS: Retrospective study of UniVATS lung resection performed between May 2012 and July 2013 at our institution. Preoperative, intraoperative and postoperative data were reviewed.

RESULTS: We performed UniVATS for 8 wedge resections (2 hook wire guided), 2 left lower lobectomies, 1 left upper lobectomy, 2 right lower lobectomies, 1 right middle lobectomy, 2 right upper lobectomies and 2 left pneumonectomy. The pathology for W were 3 benign, 3 granulomas, 2 metastatic lesions (both for colonic carcinoma metastases). Lobectomies and pneumonectomy were performed for early stage non-small cell lung carcinoma. Median port length were 3.5, 4.2, and 5.5 cm for groups W, L, and P respectively. Median intraoperative blood loss for W was 5 mls, L 80 mls and P 100 mls. Median operative durations were 47, 152, 175 minutes for W, L and P groups respectively. Median postoperative chest drainage in first day were W 90 mls, L 140mls, and P 180mls. Median chest drain duration were 1.5 days for W, 2 days for L and 1 day for P. Patients were discharged home at median postoperative day 2 for W, day 3 for L, and day 5 for P. There was no mortality or major morbidity. There were 2 minor wound infections in L group at follow-up. (median follow-up 7 months (range 0 to 14 months)).

CONCLUSIONS: Our early experiences with UniVATS lung resections suggest that it is a safe procedure with good early clinical outcomes. The long term results will need further investigation.

CLINICAL IMPLICATIONS: UniVATS approach for major lung resections can potentially further reduce surgical access trauma and improve clinical outcomes for patients.

DISCLOSURE: The following authors have nothing to disclose: Rainbow Lau, Calvin Ng, Micky Kwok, Randolph Wong, Eugene Yeung, Innes Wan, Song Wan, Malcolm Underwood

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