Article Abstract

Subxiphoid uniportal video assisted thoracoscopic surgery lobectomy, evolution of the technique and progress of learning curve

Authors: Amr Abdellateef, Chenlu Yang, Jian Chen, Jichen Qu, Jing Huang, Lei Jiang


Background: Subxiphoid uniportal video-assistedthoracoscopic surgery (SVATS) has been known as feasible and safe approach forlobectomy with acceptable results. Its learning curve is slightly harder thanthe intercostal approach. The aim of this article is to view the evolution ofthe surgical technique and the change in results with the progress of learningcurve in a trial to guide surgeons aiming to apply this technique.
Methods: Four hundred and thirty-eightpatients underwent SVATS lobectomy from September 2014 to November 2017. Thepatients were divided into four groups chronologically according to date ofoperation. Group 1, group 2, group 3 and group 4 comprise 1st 100 cases, 2nd100 cases, 3rd 100 cases and 4th 138 cases respectively. Perioperative data wasanalyzed between the four groups to study the change of different variableswith progress of the learning curve.
Results: Operative time, intraoperative bloodloss, number of dissected lymph nodes, rate of conversion and duration ofpostoperative stay have significantly improved with progress of learning curve.
Conclusions: Adjustment ofsome surgical steps and instrumentation along with developing experience havehelped SVATS lobectomy to be easier, safer and faster.