Simultaneous uniportal video-assisted thoracic surgery for pulmonary nodules and synchronous mediastinal lesions

Wideochir Inne Tech Maloinwazyjne. 2021 Jun;16(2):390-396. doi: 10.5114/wiitm.2020.101240. Epub 2020 Nov 27.

Abstract

Introduction: Video-assisted thoracic surgery (VATS) has been widely accepted in the diagnosis and treatment of thoracic diseases for the past three decades due to its small incision, minimal trauma, and rapid recovery after surgery. A growing number of patients with concurrent pulmonary nodules and mediastinal lesions have been detected. Simultaneous ipsilateral resection of coexisting lesions is a preferred procedure.

Aim: To introduce our technique and preliminary experience in performing uniportal video-assisted thoracic surgery (VATS) for the simultaneous resection of pulmonary and mediastinal lesions.

Material and methods: We retrospectively analysed 8 consecutive patients who underwent simultaneous uniportal VATS resection of coexisting lesions of the lung and mediastinum in our centre. The clinical data were recorded and analysed.

Results: A total of 8 patients were enrolled, and all patients successfully underwent surgery through a single incision; no perioperative deaths occurred. The average single incision length was 3.9 ±0.3 cm, the operative time was 102.3 ±54.4 min, and the bleeding volume was 27.5 ±17.9 ml. The thoracic drainage time was 3.0 ±2.3 days, with a mean volume of 390.6 ±361.3 ml. The length of postoperative hospital stay was 4.0 ±1.9 (range: 3-9) days. No serious complications were observed in the hospital or during postoperative follow-up.

Conclusions: Uniportal VATS is feasible and safe for the simultaneous resection of pulmonary and mediastinal lesions in selected patients and offers cosmetically pleasing incisions and promising clinical application prospects.

Keywords: mediastinal lesion; pulmonary nodule; simultaneous resection; uniportal video-assisted thoracic surgery.