Uniportal versus Multiportal Thoracoscopic Complex Segmentectomy: Propensity Matching Analysis

Purpose: Uniportal video-assisted thoracoscopic surgery (VATS) complex segmentectomy has been challenging for thoracic surgeons. This study was designed to compare the perioperative outcomes between uniportal and multiportal VATS complex segmentectomy. Methods: Data on a total of 122 uniportal and 57 multiportal VATS complex segmentectomies were assessed. Propensity score (PS) matching yielded 56 patients in each group. A crude comparison and PS matching analyses, incorporating preoperative variables, were conducted to elucidate the short-term outcomes between uniportal and multiportal VATS complex segmentectomies. Results: The uniportal group had a significantly shorter operation time (173 min vs. 195 min, p = 0.004), pleural drainage duration (2.5 d vs. 3.5 d, p <0.001), and postoperative hospital stay (4.2 d vs. 5.3 d, p <0.001) before matching, and a significant difference was also observed after matching for pleural drainage duration (2.5 d vs. 3.6 d, p <0.001) and postoperative hospital stay (4.5 d vs. 5.2 d, p = 0.001). The numbers of dissected lymph nodes in N1 and N2 stations, the intraoperative and postoperative complication rates were not significantly different between these two groups. Conclusions: The uniportal VATS complex segmentectomy was not inferior to multiportal VATS in terms of perioperative outcomes and therefore should be considered as a viable surgical approach for treatment.