Uniportal video-assisted thoracoscopy surgery in lung cancer: largest experience

Background Uniportal video-assisted thoracoscopic surgery is one of the latest development in minimal invasive thoracic surgery. It is being increasing applied in various parts of the world for the treatment of lung cancer. Although the technique has become popular, there is a lack of largescale literature addressing the safety and oncological outcomes. We aimed to describe our experience, highlighting the short-term outcomes and oncological efficacy. Methods From July 2013 to December 2017, 441 uniportal video-assisted thoracoscopic procedures were carried out in patients with primary lung cancer and no metastatic disease. The male-to-female ratio was 240:201. The median age of the patients was 63 years (range10 to 85 years). Results The median number of mediastinal lymph node stations dissected and median number of mediastinal nodes were 5 and 14, respectively. Ten or more nodes were dissected in 93.1% of patients. All surgeries were complete R0 resection. Minor postoperative morbidity according to the Clavien-Dindo classification was 4%. Seven patients experienced major morbidity requiring intensive care management. There was no 30-day mortality. Conclusion Uniportal video-assisted thoracoscopic anatomical resection for lung cancer appears to have similar postoperative outcomes to multiport surgery in terms of short-term morbidity and oncological efficacy. Uniportal video-assisted thoracoscopic surgery can be offered as a standard of care for lung cancer surgery in centers with adequate surgical expertise. Long-term follow-up will be needed to establish the long-term oncological outcomes.