ABSTRACT
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is a new area of exploration and evolution in thoracic minimal invasive surgery. The uniportal VATS approach has become popular during lung resection for small nodules and ground glass lesions. Our objective is to investigate the efficacy, availability and safety of uniportal VATS anatomical segmentectomy compared with conventional VATS in patients for lung resection. METHODS: Surgical patients of perioperative period who admitted and underwent uniportal, two-port and conventional three-port VATS segmentectomy were analyzed and compared retrospectively during the year 2017 to 2018. RESULTS: During the research period, of 111 patients who had VATS anatomical segmentectomy, 38 underwent uniportal, 43 underwent two-port, and 30 underwent three-port VATS. Four patients underwent conversion to thoracotomy. There were no postoperative mortalities, and there were no significant differences among the three groups in surgical outcomes, including operative time, blood loss, conversions to thoracotomy, drainage time and volume, lymph node dissection, postoperative complications and hospital stay. The pain scores of visual analog scale (VAS) significantly decreased in uniportal group when operation is finished (P < 0.05). CONCLUSION: This study demonstrates that uniportal VATS anatomical segmentectomy is a quite safe surgical technology, as well as feasible, which can cause reduced postoperative pain and less surgical trauma compared to conventional VATS. More experiences and observations of large samples are on the way.
Subject(s)
Lung Neoplasms , Thoracic Surgery, Video-Assisted , Humans , Lung , Lung Neoplasms/surgery , Pneumonectomy , Retrospective StudiesABSTRACT
BACKGROUND: The aim of this meta-analysis was to compare the benefits of postoperative adjuvant chemotherapy vs. observation for stage IB non-small cell lung cancer (NSCLC). METHODS: A literature search was performed in PubMed, Embase, and Cochrane Library databases, and stage IB NSCLC patients were assigned to the postoperative adjuvant chemotherapy and observation groups. The 5-year overall survival (OS), 5-year disease-free survival (DFS), local recurrence, and distant metastasis were then assessed. In addition, statistical analysis was conducted using Review Manager 5.3 software. RESULTS: The meta-analysis involved nine articles and included 1,645 stage IB patients. There was no significance in the 5-year OS [relative risk (RR) =1.05; 95% confidence interval (CI): 0.98-1.13; P=0.14] and 5-year DFS (RR =1.29; 95% CI: 0.97-1.72; P=0.08) between the postoperative adjuvant chemotherapy and observation groups. However, there was a significant difference in local recurrence (RR =0.43; 95% CI: 0.23-0.80; P=0.007) and distant metastasis (RR =0.68; 95% CI: 0.48-0.97; P=0.03) between the two groups. CONCLUSIONS: Adjuvant chemotherapy might not be recommended for stage IB NSCLC.
