Innovative Techniques in Video-Assisted Thoracoscopic Surgery: Lu's Approach

Baofeng Wang; Jiang Wang; Tongyu Sun; Yilin Ding; Shasha Li; Hengxiao Lu

doi:10.2147/LCTT.S446418

Innovative Techniques in Video-Assisted Thoracoscopic Surgery: Lu's Approach

Lung Cancer (Auckl). 2024 Feb 2:15:9-17. doi: 10.2147/LCTT.S446418. eCollection 2024.

Authors

Baofeng Wang^#^{1

2}, Jiang Wang^#², Tongyu Sun², Yilin Ding², Shasha Li³, Hengxiao Lu²

Affiliations

¹ School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, People's Republic of China.
² Department of Thoracic Surgery, Weifang People's Hospital, Weifang, Shandong, People's Republic of China.
³ Clinic, Weifang People's Hospital, Weifang, Shandong, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Lu's approach for video-assisted thoracoscopic surgery (LVATS), which derives from Uniportal Video-Assisted Thoracoscopic Surgery(UVATS), is a novel surgical approach for VATS and carries out micro-innovation for lung cancer resection. The objective of this study is to elucidate the safety, feasibility, and efficacy of this novel surgical approach.

Patients and methods: The clinical data of patients with non-small cell lung cancer (NSCLC) who underwent a curative thoracoscopic lobectomy between Mar. 2021 and Mar. 2022, were retrospectively collected and analyzed. Patients were divided into the LVATS group and the UVATS group. Propensity score matching (PSM) was used to reduce selection bias and create two comparable groups. Perioperative variables were compared, and a p-value < 0.05 was deemed statistically significant.

Results: A total of 182 patients were identified, among whom 86 patients underwent LVATS and 96 UVATS. Propensity matching produced 62 pairs in this retrospective study. There were no deaths during perioperative period. Patients in the LVATS group experienced a shorter operation time (88 (75, 106) VS 122 (97, 144) min, P <0.001), less intraoperative blood loss (20 (20, 30) VS 25 (20, 50) mL, P = 0.021), shorten incision length (2.50 (2.50, 2.50) VS 3.00 (3.00, 3.50) cm, P <0.001), and more drainage volume (460 (310, 660) VS 345 (225, 600) mL, P = 0.041) than patients in the UVATS group. There was not significant difference in the lymph node stations dissected (5 (4, 5) VS 5 (4, 5), P = 0.436), drainage duration (3 (3, 4) VS 3 (3, 4) days, P =0.743), length of postoperative hospital stay (4 (4, 5) VS 4 (4, 6) days, P = 0.608), VAS on the POD1 (4 (4, 4) VS 4 (4, 4), P=0.058) and POD3 (3 (3, 4) VS 4 (3, 4), P=0.219), and incidence of postoperative complications (P=0.521) between the two groups.

Conclusion: Lu's approach for video-assisted thoracoscopic lobectomy is safe and feasible, potentially reducing surgery time, incision length, and intraoperative blood loss.

Keywords: Lu’s approach for VATS; lobectomy; non-small cell lung cancer; uniportal video-assisted thoracoscopic surgery.

Grants and funding

This research was supported by the Weifang Municipal Health and Health Committee Fund, with the project number WFWSJK-2023-321.