Single-Port Thoracoscopic Surgery via Areola Approach for Lung Cancer: Feasibility, Safety, and Initial Experience...

Single-port thoracoscopic surgery (SPTS) has emerged as a cornerstone of minimally invasive lung cancer management. However, visible chest wall scars remain a persistent concern. The pursuit of scarless surgery has driven the exploration of concealed incision techniques. This study evaluates the feasibility and safety of a novel areola-concealed incision approach for SPTS in lung cancer resection.

Following the administration of successful general anesthesia, an incision measuring approximately one-sixth to one-third of the areolar circumference was made along its outer margin. Between April and July 2024, 33 patients with early-stage lung cancer underwent SPTS via periareolar incision. Technical success, operative metrics, complications, and cosmetic outcomes were prospectively analyzed.

All procedures were completed without conversion to multi-port or open surgery. The average surgical time was 107.1 min, with an average intraoperative bleeding of 33 mL. Chest tubes were removed at a median of 3 days postoperatively. At 3-month follow-up, all incisions healed without visible scarring, and nipple-areola complex integrity was preserved. No major complications occurred.

The areola-concealed SPTS technique demonstrates safety and technical feasibility for early-stage lung cancer, achieving scarless outcomes while maintaining oncological rigor. This approach may redefine aesthetic standards in minimally invasive thoracic surgery.

Chinese Clinical Trial Registry: ChiCTR2400083283.