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Outcomes Of 500 Consecutive Uniportal Video-Assisted Lobectomies.

Objectives We present the outcomes of 500 consecutive uniportal video-assisted lobectomies performed at our department. Materials and Methods Between November 2013 and July 2020, 500 lobectomies (malignant lesions: 468 cases, benign lesions: 32 cases) were performed. The patients' demographics, approach and type of surgery, postoperative morbidity and mortality were analyzed. Results Demographical data are as follows: 216 female/284 male, mean age: 63 years (range: 16-85 years). All surgeries began by a single-port VATS approach, being necessary conversion to mini-thoracotomy in 45 procedures (conversion rate of 9%) due to bleeding and/or technical difficulties. The resected lobes showed the following distribution: right upper: 167, mid lobe: 33, right lower: 82, left upper: 111, left lower: 77, upper bilobectomy: 17; lower bilobectomy: 7. In six cases sleeve lobectomy was performed. The median surgical time was 90 minutes (range 25-305 minutes) and median intra-operative drainage was 100ml (range 20-2100ml). Median hospitalization time was 5 days (range 2-40 days). Postoperative complication rate was 25% (with the persistent air leakage being the most frequent complication: 102 patients (20.4%). Reoperation for bleeding occurred in 7 patients (1.4%). There was no operative or 30-days mortality. Among the 468 VATS lobectomies performed due to malignant lesions, 450 lung cancers and 18 metastases were removed. The distribution according to the stage and histology of lung cancers was as follows: 0: 5, IA: 173, IB: 148, IIA: 45, IIB: 39, IIIA: 38 and IIIB: 2; adenocarcinoma: 327, squamous cell carcinoma: 54, small cell carcinoma: 1, non- -small cell lung carcinoma: 1, carcinoid: 67. Conclusions With the results in our institution this approach has demonstrated to be reproducible, comprising all the advantages of a minimal invasive surgery, without jeopardizing the efficiency of the oncologic treatment. Nowadays, in our department, more than 95% of lobectomies are performed with minimally invasive technique.