|Table of Contents|

Comparative study on the application effect of single-port 3D thoracoscopy with different approaches in the resection of stage Ⅰ-Ⅱ non-small cell lung cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 01
Page:
66-70
Research Field:
Publishing date:

Info

Title:
Comparative study on the application effect of single-port 3D thoracoscopy with different approaches in the resection of stage Ⅰ-Ⅱ non-small cell lung cancer
Author(s):
LI Wei1; ZHENG Zhongfeng1; YOU Jinzhi1; SHAO Feng2
1.Department of Thoracic Surgery,Suqian Hospital of Nanjing Drum Tower Hospital Group,Jiangsu Suqian 223800,China;2.Department of Thoracic Surgery,Nanjing Brain Hospital,Jiangsu Nanjing 210029,China.
Keywords:
subxiphoid approach; transcostal approach; single-port thoracoscopy; early stage; non-small cell lung cancer; surgery; effect
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2023.01.011
Abstract:
Objective:To compare the application effect of single port 3D thoracoscopy through the subxiphoid approach and the transcostal approach in the resection of stage Ⅰ-Ⅱ non-small cell lung cancer(NSCLC).Methods:The clinical data of 83 patients with stage Ⅰ-Ⅱ who underwent single-port 3D thoracoscopic NSCLC resection at the Department of Thoracic Surgery in our hospital from July 2018 to February 2020 were retrospectively analyzed.Among them,43 cases of single port 3D thoracoscopic NSCLC resection via subxiphoid approach(study group),40 cases of single port 3D thoracoscopic NSCLC resection via intercostal approach(control group).The postoperative follow-up was 12 months.The relevant clinical indicators of the two groups were compared.Results:The blood loss during operation and the postoperative chest tube indwelling time in the study group were lower than control group(169.83 mL vs 210.47 mL,4.24 d vs 4.89 d,P＜0.05).The operation time of the study group was higher than control group(154.16 min vs 142.38 min,P＜0.05).The visual analogue scale(VAS) of pain at 12 h,24 h and 48 h after operation in the study group were lower than control group(4.01 points vs 4.39 points,4.43 points vs 4.97 points,2.84 points vs 3.21 points,P＜0.05).The levels of prostaglandin E2(PEG2) and substance P(SP) at 24 h and 48 h after the operation in the study group were lower than those in the control group(264.02 pg/mL vs 316.28 pg/mL,221.13 pg/mL vs 272.28 pg/mL,2.02 μg/mL vs 2.39 μg/mL,1.62 μg/mL vs 2.07 μg/mL,P＜0.05).There was no significant difference in the forced expiratory volume in the first second(FEV1) between the two groups before operation,1 month after operation,and 12 months after operation(2.49 L vs 2.43 L,1.61 L vs 1.57 L,2.33 L vs 2.29 L,P＞0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(15.00% vs 11.63%,P＞0.05).There was no death in the two groups after 12 months,and the difference in recurrence rate and distant metastasis rate between the two groups was not statistically significant(4.65% vs 7.50%,2.33% vs 5.00%,P＞0.05).Conclusion:Compared with the transcostal approach,single port 3D thoracoscopic NSCLC resection through the subxiphoid approach has the advantages of less intraoperative blood loss,shorter postoperative chest tube indwelling time,and less postoperative pain.However,two approaches are available.The short-term prognosis is similar.

References:

[1]DUMA N,SANTANA-DAVILA R,MOLINA JR.Non-small cell lung cancer:Epidemiology,screening,diagnosis,and treatment［J］.Mayo Clin Proc,2019,94(8):1623-1640.
[2］ARBOUR KC,RIELY GJ.Systemic therapy for locally advanced and metastatic non-small cell lung cancer:A review［J］.JAMA,2019,322(8):764-774.
[3］HUNG WT,CHENG YJ,CHEN JS.Video-assisted thoracoscopic surgery lobectomy for lung cancer in monintubated anesthesia［J］.Thorac Surg Clin,2020,30(1):73-82.
[4］GALVEZ C,BOLUFER S,GALVEZ E,et al.Anatomic segmentectomy in nonintubated video-assisted thoracoscopic surgery［J］.Thorac Surg Clin,2020,30(1):61-72.
[5］KOIKE T,SATO S,TSUCHIDA M.A novel suture technique in closing the single drainage tube hole in uni-portal video-assisted thoracoscopic surgery［J］.Ann Transl Med,2020,8(7):424-427.
[6］PARK SY,HAN KN,HONG JI,et al.Subxiphoid approach for robotic single-site-assisted thymectomy［J］.Eur J Cardiothorac Surg,2020,58(1):34-38.
[7］NAGANO H,SUDA T,ISHIZAWA H,et al.Video-assisted thoracoscopic surgery for ectopic mediastinal parathyroid tumor:subxiphoid and lateral thoracic approach［J］.J Thorac Dis,2019,11(7):2932-2938.
[8］张勇，王哲，张广健，等.经剑突下胸腔镜技术在前纵隔肿瘤外科治疗中的应用［J］.现代肿瘤医学，2017,25(11):1731-1733. ZHANG Yong,WANG Zhe,ZHANG Guangjian,et al.Clinical application of subxyphoid approach video-assisted thoracoscopic surgery for treatment of anterior mediastinal tumors［J］.Modern Oncology,2017,25(11):1731-1733.
[9］SHIOMI K,KITAMURA E,ONO M,et al.Feasible and promising modified trans-subxiphoid thoracoscopic extended thymectomy for patients with myasthenia gravis［J］.J Thorac Dis,2018,10(3):1747-1752.
[10］ETTINGER DS，AISNER DL，WOOD DE,et al.NCCN guidelines insights： Non-small cell lung cancer， version 5.2018［J］.J Natl Compr Canc Netw,2018,16(7):807-821.
[11］SUNG YT,WU JS.The visual analogue scale for rating,ranking and paired-comparison(VAS-RRP):A new technique for psychological measurement［J］.Behav Res Methods,2018,50(4):1694-1715.
[12］MACDOWALL A,SKEPPHOLM M,ROBINSON Y,et al.Validation of the visual analog scale in the cervical spine［J］.J Neurosurg Spine,2018,28(3):227-235.
[13］BRODERICK SR.Adjuvant and neoadjuvant immunotherapy in non-small cell lung cancer［J］.Thorac Surg Clin,2020,30(2):215-220.
[14］IMPERATORI A,FONTANA F,DOMINIONI L,et al.Video-assisted thoracoscopic resection of lung nodules localized with a hydrogel plug［J］.Interact Cardiovasc Thorac Surg,2019,29(1):137-143.
[15］ETTINGER DS,WOOD DE,AGGARWAL C,et al.NCCN guidelines insights:Non-small cell Lung cancer,version 1.2020［J］.J Natl Compr Canc Netw,2019,17(12):1464-1472.
[16］KRIS MG,GASPAR LE,CHAFT JE,et al.Adjuvant systemic therapy and adjuvant radiation therapy for stage I to IIIa completely resected non-small-cell lung cancers:American society of clinical oncology/cancer care ontario clinical practice guideline update［J］.J Clin Oncol,2017,35(25):2960-2974.
[17]张淼,武文斌,杨敦鹏,等.剑突下与肋间入路胸腔镜胸腺扩大切除术的临床体会［J］.中华腔镜外科杂志,2019,12(3):166-170. ZHANG M,WU WB,YANG DP,et al.Clinical experience of subxiphoid and intercostal approach thoracoscopic enlarged thymectomy［J］.Chinese Journal of Endoscopic Surgery,2019,12(3):166-170.
[18]钟斌,童继春,张明,等.经剑突下与经侧胸入路胸腔镜手术在胸腺瘤切除中的应用比较［J］.广东医学,2019,40(3):383-386. ZHONG B,TONG JC,ZHANG M,et al.Application comparison of subxiphoid and translateral thoracoscopic thoracoscopic surgery in thymoma resection［J］.Guangdong Medical Journal,2019,40(3):383-386.
[19]李忠望,贡会元,李洪林,等.全腔镜肺叶切除与开胸肺叶切除治疗早期肺癌1年随访［J］.中国老年学杂志,2020,40(8):1636-1640. LI ZW,GONG HY,LI HL,et al.One-year follow-up of full laparoscopic lobectomy and thoracotomy for early lung cancer［J］.Chinese Journal of Gerontology,2020,40(8):1636-1640.
[20］ARESU G,WEAVER H,WU L,et al.The Shanghai Plmonary Hospital uniportal subxiphoid approach for lung segmentectomies［J］.J Vis Surg,2016,2(1):172-175.

Memo

Memo:
江苏省南京市卫生健康委员会基金项目（编号：ZKX19046）
Last Update: 2022-11-30