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Uniportal VATS Lobectomy: Subxiphoid Approach.

Catarina Carvalheiro¹, Javier Gallego-Poveda¹, Diego Gonzalez-Rivas²

¹Fundação Champalimaud, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular

|April 28, 2018

Summary

This summary is machine-generated.

The subxiphoid approach for uniportal video-assisted thoracic surgery (VATS) offers reduced pain and excellent cosmetic outcomes for lung resections. This minimally invasive technique shows promise but requires further study for complex oncologic dissections.

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Area of Science:

Thoracic Surgery
Minimally Invasive Surgery
Video-Assisted Thoracic Surgery (VATS)

Background:

Uniportal VATS is gaining popularity for lung procedures due to minimal trauma.
The subxiphoid approach, a variant of uniportal VATS, is increasingly used for its pain reduction and cosmetic benefits, avoiding intercostal nerve damage.

Observation:

A case study of a 66-year-old male with a right upper lobe lung nodule.
The patient presented with cough and mild bronchial obstruction, necessitating surgical intervention.
A subxiphoid uniportal lung resection was performed for a suspected adenocarcinoma.

Findings:

The subxiphoid approach allowed for a right upper lobectomy and mediastinal lymphadenectomy with excellent pain control (Visual Analogue Scale 1).
The patient experienced an uneventful postoperative recovery, with chest tube removal on day 3 and discharge on day 4.
Intraoperative histological examination confirmed adenocarcinoma, leading to lobectomy and lymphadenectomy via the same approach.

Implications:

The subxiphoid approach offers significant advantages in pain management and cosmesis for selected thoracic surgery patients.
Challenges remain in managing major bleeding and ensuring complete oncologic lymph node dissection due to surgical complexity.
Further research is essential to validate the feasibility, safety, and benefits of this emerging surgical technique.