One-port videothoracoscopic surgical intervention.

BACKGROUND

One-port video-assisted thoracic surgery (VATS) has recently been proposed as an alternative to conventional 3-port VATS. To reduce pain, chest wall paresthesia, and hospital stay, lesser ports are the current direction.

MATERIALS AND

METHODS

From 2007 to 2010, 98 patients underwent 1-port VATS procedure. The charts were retrospectively evaluated. A 2.5 cm long incision was made at the sixth intercostal space in the median axillary line. A single flexible port was used. Both the camera and the endoinstruments were introduced through the port. Patient characteristics, visual analog score, and postoperative paresthesia scores were evaluated.

RESULTS

The study enrolled 38 women and 60 men with the mean age of 49.1±1.5 years (range, 19 to 75 y). Thirty-one patients (28.6%) were diagnosed with malignant pleural effusion. Perioperative pleurodesis with talc was performed in 81% of them. One-port VATS approach was used for pleura biopsies in 77 (78.6%), wedge resection in 4 (3.8%), pleurectomy in 13 (12.4%), and biopsy with talc chemical pleurodesis in 4 (3.8%) instances. The mean operation time was 24.4 minutes (range, 15 to 50 min). No major cardiorespiratory or surgical complications were noted. The median observation time was 60 months (range, 36±81 mo). Among benign pathology patients, 56 (82.3%) of them did not complain about any pain; however, 12 patients had prolonged discomfort (2 pinprick, 6 numbness, and 4 pruritus).

CONCLUSIONS

One-port VATS in selected patients are feasible and seems to be safe in thoracic surgical interventions instead of conventional 3 ports that was presented in this series.