Initial experience with uniportal video-assisted thoracoscopic surgery for the treatment of lung cancer performed by a surgeon who did not have previous experience performing multiportal thoracoscopic surgery: a single center retrospective study

BACKGROUND: The purpose of this study was to evaluate the surgical outcome of uniportal video-assisted thoracoscopic surgery (VATS) for the treatment of non-small cell lung cancer performed by a surgeon who did not have previous experience performing open thoracotomy and multiportal VATS. METHODS: From January 2017 to December 2018, 85 patients underwent uniportal VATS anatomical pulmonary resection performed by one surgeon. The remaining 269 patients underwent multiportal VATS performed by other experienced surgeons. Clinicopathological characteristics and surgical outcomes of the uniportal VATS and multiportal VATS groups were compared. RESULTS: The uniportal VATS procedures included 7 segmentectomies, 66 lobectomies, 1 bilobectomy, and 1 pneumonectomy. There was no conversion to multiportal VATS or open thoracotomy. Patients who underwent multiportal VATS surgery were older, more often men, and more often smokers than those who underwent uniportal VATS. Other clinicopathological characteristics were not statistically different between the two groups. The number of dissected lymph nodes was higher in uniportal VATS than in multiportal VATS (16.8 vs. 14.6, P=0.030). Anesthetic time and operative time were shorter in uniportal VATS than in multiportal VATS (both P<0.001). Intraoperative blood loss was also less in the uniportal VATS group than in the multiportal VATS group (P<0.001). There were no statistical between-group differences in chest tube drainage period, hospital stay, postoperative complication rate, and operative mortality rate. CONCLUSIONS: Uniportal VATS for pulmonary anatomical resection of non-small cell lung cancer performed by a surgeon without previous multiportal VATS experience yielded acceptable surgical outcomes.