Comparison of single port versus multiport thoracoscopic segmentectomy

Single-port thoracoscopic segmentectomy is a challenging option in the early stages of lung cancer. The purpose of this study was to determine the feasibility of single-port video-assisted thoracoscopic surgery (VATS) segmentectomy compared to conventional multi-port VATS.

A total of 45 patients underwent pulmonary segmentectomy by video-assisted thoracoscopic surgery between March 2006 and October 2015. We analyzed the operative outcomes of segmentectomy by surgical approach (34 single-port versus 11 multi-port).

Twenty-three primary lung cancers (51.1%), 16 benign lung diseases (35.6%), and 6 secondary lung cancers (13.3%) were diagnosed and included in our study. In 29 malignancy cases (64.4%), the mean tumor size was 1.8±0.7 (range, 1-3.5) cm. Twenty patients (44.4%) underwent preoperative localization with hook-wire and radiocontrast. The most frequent operated segment was the left upper divisional segment (n=9, 30%). There was no significant difference in operation time (P=0.073), the number of dissected lymph nodes (P=0.310), intraoperative events (P=0.412), and the development of prolonged air leak (>5 days) (P=0.610) between the single-port and multi-port VATS segmentectomy groups. There was a reduction in postoperative morbidity (P<0.001) and hospital stay (P=0.029) in the single-port VATS group.

Single-port VATS segmentectomy for early lung cancer and benign lung disease, is a safe and feasible option for patients undergoing pulmonary segmentectomy.