Safety, efficacy, and postoperative pulmonary function recovery of uniportal and multiportal thoracoscopic lung...

Lung diseases often require surgical intervention for effective management, and with the evolution of thoracoscopic techniques, minimally invasive options like single-port video-assisted thoracoscopic surgery (VATS) have gained prominence over traditional open surgery due to their reduced invasiveness and improved outcomes. Despite its promising benefits, single-port VATS still encounters challenges that demand further investigation to optimize its clinical application. Therefore, this study aimed to compare the safety, efficacy, and postoperative lung function recovery between single-port and multiport thoracoscopic lung segmentectomy.

Clinical data of a total of 105 patients with lung diseases admitted to our hospital (January 2021 to December 2022) were retrospectively analyzed. Based on different surgical approaches, patients were divided into single-port (single-port thoracoscopic lung segmentectomy, n=82) and the multiport (multiport thoracoscopic lung segmentectomy, n=23) groups. Surgical time, intraoperative blood loss, conversion to open surgery rate, length of hospital stays, hospitalization costs, complication and reoperation rates, Visual Analog Scale (VAS) scores, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, and carbon monoxide diffusion capacity (DLCO) were compared between the two groups.

There were no significant differences in surgical time, conversion to open surgery rate, and reoperation rates between the two groups (P>0.05). The single-port group exhibited lower intraoperative blood loss than the multiport group (P<0.05). The length of hospital stays, hospitalization costs, short-term and long-term complication rates were lower in the single-port group compared to the multiport group (P<0.05). Preoperative VAS scores did not differ significantly between the groups (P>0.05), but the VAS scores at 1 and 3 days postoperatively were lower in the single-port group than in the multiport group (P<0.05). Preoperative FVC, FEV1, FEV1/FVC ratio, and DLCO did not significantly differ between the groups (P>0.05); however, at 1 and 3 months postoperatively, FVC, FEV1, FEV1/FVC ratio, and DLCO were superior in the single-port group compared to the multiport group (P<0.05).

In comparison with multiport VATS, single-port VATS demonstrates higher efficacy and safety and promotes better postoperative lung function recovery, and reduces postoperative pain, surgical time, incision length, intraoperative bleeding, length of hospital stay, and hospitalization costs.