Subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for lobectomy: a report of 105 cases

Abstract

Background: To address the feasibility and advantages of subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for lobectomy.

Methods: Since August 2014, 105 cases of subxiphoid uniportal VATS lobectomy were successfully performed. The clinical information was retrospectively analyzed.

Results: 96 cases underwent unilateral operation and 9 underwent bilateral operations. Surgeries were successfully performed with a complication rate of 10.5%. The average pain scores 8 hours, day 1, 2 and 3 after surgery, as well as the day before discharge were 2.39±0.99, 2.06±0.85, 1.68±0.87, 1.29±0.78, and 0.48±0.51, respectively, which were significantly lower than those in the control group (standard intercostal uniportal VATS) (P<0.001).

Conclusions: The subxiphoid uniportal VATS lobectomy is safe and reliable, which is appropriate for bilateral lung diseases, and significantly relieves postoperative incision pain.

Keywords: Thoracoscope; lobectomy; subxiphoid; uniportal.

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1

Pre-operative position.

Figure 2

Several surgical steps of VATS lobectomy through subxiphoid approach. (A) Division of the upper apico-anterior arterial trunk in right upper lobectomy; (B) division of right upper lobe bronchus; (C) division of the left lower lobe artery; (D) division of the left lower lobe vein. VATS, video-assisted thoracoscopic surgery.

Figure 3

A drainage tube was inserted through the subxiphoid incision, and a deep venous puncture catheter was inserted though the lateral chest wall.

Figure 4

Bilateral pleural drainage tubes were inserted through the subxiphoid incision in bilateral resections.