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Measurement of the Pressure-volume Curve in Mouse Lungs
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Learning curve and subxiphoid lung resections most common technical issues.

Luis Angel Hernandez-Arenas1, William Guido2, Lei Jiang1

  • 1Department of Thoracic Surgery, Shanghai Pulmonary Hospital affiliated to Tongji University School of Medicine, Shanghai 200433, China.

Journal of Visualized Surgery
|February 6, 2018
PubMed
Summary
This summary is machine-generated.

Subxiphoid uniportal video-assisted thoracic surgery (SVATS) for lung resections shows a learning curve with reduced operating times and conversion rates. This study offers practical tips and tricks for managing intraoperative challenges in SVATS programs.

Keywords:
VATSsubxiphoiduniportal

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Subxiphoid uniportal video-assisted thoracic surgery (SVATS) is an emerging technique for major lung resections.
  • Limited clinical evidence exists for SVATS, necessitating evaluation of its learning curve and technical aspects.
  • Early experiences with SVATS and transthoracic uniportal VATS inform best practices.

Purpose of the Study:

  • To describe the learning curve associated with SVATS for lung resections in 200 patients.
  • To identify and address intraoperative technical difficulties encountered during SVATS.
  • To provide recommendations and "tips and tricks" for establishing a SVATS program.

Main Methods:

  • Prospective description of the learning curve for the first 200 patients undergoing uniportal subxiphoid lobectomy or segmentectomy.
  • Comparison of operating times and conversion rates between the first 100 cases (Group 1) and the subsequent 100 cases (Group 2).
  • Inclusion of patients with early-stage non-small cell lung carcinoma (NSCLC) and benign lung diseases.

Main Results:

  • A total of 200 patients (72 males, 128 females) underwent SVATS, with 136 lobectomies and 64 segmental resections.
  • The mean operating time was 170±45 minutes, with operating times stabilizing after case 86.
  • The conversion rate decreased from 13% in Group 1 to 8% in Group 2, indicating improved proficiency.

Conclusions:

  • Increasing experience with SVATS leads to a gradual reduction in operating time and conversion rates.
  • The study provides a troubleshooting guide with "tips and tricks" based on early SVATS experience.
  • These insights aid in managing intraoperative challenges and establishing effective SVATS programs.