[Thoracoscopic pneumonectomy for lung cancer: a retrospective cohort study]

To analyze the correlation between neoadjuvant treatment and postoperative morbidity; to assess immediate postoperative outcomes after open and thoracoscopic pneumonectomy (MultiPort and UniPort groups).

A retrospective analysis included data from 100 patients who underwent open, thoracoscopic multiport and single-port pneumonectomy for lung cancer. Correlations were assessed using univariate and multivariate regression.

The study included data of patients after open (n=51), thoracoscopic multiport (n=49), and single-port (n=29) pneumonectomy between 2016 and 2023. Neoadjuvant therapy was not associated with higher incidence of postoperative complications (p=0.123). Thoracoscopic access was associated with lower risk of postoperative complications (26.5% and 39.2%, respectively; p=0.177) and length of hospital stay (11.47 and 15.16 days, respectively; p=0.086) compared to open access, but differences were not significant. Multiport access was accompanied by higher rate of hemothorax (20%) compared to open (7.9%) and single-port (0%) access groups (p=0.04). Open surgery was followed by higher rate of recurrent laryngeal nerve paresis (19.6% versus 0% in thoracoscopic group; p=0.005). No significant between-group differences were found regarding incidence of bronchopleural fistula (p=0.183) or postoperative mortality (p=0.118).

Thoracoscopic pneumonectomy is characterized by equal effectiveness compared to open technique and also demonstrates a tendency to lower incidence of postoperative complications and length of postoperative hospital stay.