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225 posters, 34 videos, 18 topics, 14 sessions, 251 authors, 55 institutions

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ISMICS 2024 Annual Meeting

29 May - 1 June, 2024 | Athens, Greece

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PC.120

Mini-invasive Thoracic Surgery For Early-stage Lung Cancer: Which Is The Best Surgeon's Approach To Video-assisted Thoracic Surgery?

Poster Presenter

Beatrice Trabalza Marinucci

Authors

Beatrice Trabalza Marinucci

Part of Topic

Thoracic Surgery

MINI-INVASIVE THORACIC SURGERY FOR EARLY-STAGE LUNG CANCER: WHICH IS THE BEST SURGEON’S APPROACH TO VIDEO-ASSISTED THORACIC SURGERY?

Objective

The advantages of Video Assisted Thoracic Surgery (VATS) for an enhanced recovery after surgery are well known. The choice of the best mini-invasive surgical approach is still debating, balancing between innovation and self-confidence for the surgeon. The aim of the study is to report the results of a high-volume centre, comparing data of Uni-portal, Bi-portal and Tri-portal VATS.

Methods

•2015-2022: 210 matched patients underwent VATS lobectomy for early-stage lung cancer.
•Matching: age, BPCO, smoking habit, comorbidities, pathology (stage and size).
•Three homogeneous groups: 70 Uni-portal (UVATS-A); 70 Bi-portal (BIVATS-B); 70 Tri-portal (TRIVATS-C).
•Surgical Access: uni-portal (on the fifth intercostal space), bi-portal (the seventh space for optic and the fifth), tri-portal (the seventh and the fifth/four on anterior and posterior axillary line).
Surgeons had comparable expertise.

Results

•No significant differences in time of surgery, length of hospital stay, complications, conversion rate, specific survival, pain, days of chest tube permanence.
•Better results in days of chest tube permanence  were described in group A (mean 1.1 days) compared to group B (mean 2.6 days) and C (mean 4.7 days), even not statistically significant (p=0.106).

Conclusions

The minor chest tube permanence in site in the uni-portal group allows to hypothesize an enhanced recovery after surgery in this set of patients. 

Nevertheless, the three approaches in this series seem to guarantee comparable safety, effectiveness, and oncological results. 

In conclusion, considering the non-superiority of one method over the others, the best suggested approach is the one for which surgeon feels more confident.  

Self-confidence and personal safety for surgeons guarantee the most effective result for patients.

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