Anterior fissureless uniport vs. posterior intra-fissure triple-port thoracoscopic right upper lobectomy: a propensity-matched study

摘要

Background: This study aimed to assess the efficiency of anterior fissureless uniport (AFU) thoracoscopic lobectomy for early stage right upper non-small cell lung cancer (NSCLC). Methods: Between June 2014 and Dec 2016, 162 consecutive NSCLC patients who underwent thoracoscopic right upper lobectomy (RUL) by AFU approach (AFU group, n=65) or posterior intra-fissure triple-port dissection (PIFT group, n=97) were enrolled. A propensity-matched analysis was used to compare perioperative outcomes, safety and efficiency between the two groups. Results: Propensity matching produced 40 pairs in this retrospective study. During the operation, lobectomy took less time in the AFU group compared with the PIFT group, while no statistical differences in mediastinal lymphadenectomy time, intraoperative blood loss, and total of lymph nodes harvested were found between the two groups. Postoperatively, length of hospital stay (LOS) and time of postoperative air leak were significantly reduced in AFU group than in PIFT group. However, the overall complication rate and volume of pleural effusion drainage within 48 h were similar. Compared with the PIFT group, visual analogue scale (VAS) of 3 postoperative days in AFU group was slighter. Conclusions: In RUL, AFU thoracoscopic approach is safe, efficient and easily maneuverable, which would reduce the duration of lobectomy, LOS and time of postoperative air leak. Postoperative pain is also mild.