• Media type: E-Article
  • Title: Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database
  • Contributor: Tosi, Davide; Nosotti, Mario; Bonitta, Gianluca; Mazzucco, Alessandra; Righi, Ilaria; Mendogni, Paolo; Rosso, Lorenzo; Palleschi, Alessandro; Rocco, Gaetano; Crisci, Roberto; Mancuso, M; Pernazza, F; Refai, M; Bortolotti, L; Rizzardi, G; Gargiulo, G; Dolci, G P; Perkmann, R; Zaraca, F; Benvenuti, M; Gavezzoli, D; Cherchi, R; Ferrari, P; Mucilli, F; [...]
  • imprint: Oxford University Press (OUP), 2019
  • Published in: Interactive CardioVascular and Thoracic Surgery
  • Language: English
  • DOI: 10.1093/icvts/ivz153
  • ISSN: 1569-9285
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of dissected lymph nodes and length of stay.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>This was an observational, retrospective, cohort, multicentre study on data collected by 49 Italian thoracic units. Inclusion criteria were clinical stage I–II non-small-cell lung cancer, uniportal or 3-portal VATS lobectomy and R0 resection. Exclusion criteria were cT3 disease, previous thoracic malignancy, induction therapy, significant comorbidities and conversion to other techniques. The pain parameter was dichotomized: the numeric rating scale ≤3 described mild pain, whereas the numeric rating scale score &amp;gt;3 described moderate/severe pain. The propensity score-adjusted generalized estimating equation was used to compare the uniportal with 3-portal lobectomy.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Among 4338 patients enrolled from January 2014 to July 2017, 1980 met the inclusion criteria; 1808 patients underwent 3-portal lobectomy and 172 uniportal surgery. The adjusted generalized estimating equation regression model using the propensity score showed that over time pain decreased in both groups (P &amp;lt; 0.001). There was a statistical difference on the second and third postoperative days; odds ratio (OR) 2.28 [95% confidence interval (CI) 1.62–3.21; P &amp;lt; 0.001] and OR 2.58 (95% CI 1.74–3.83; P &amp;lt; 0.001), respectively. The uniportal-VATS group had higher operative time (P &amp;lt; 0.001), shorter chest drain permanence (P &amp;lt; 0.001) and shorter length of stay (P &amp;lt; 0.001).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Data from the Italian VATS Group Database showed that in clinical practice uniportal lobectomy seems to entail a higher risk of moderate/severe pain on second and third postoperative days.</jats:p> </jats:sec>
  • Access State: Open Access