Single-Incision Thoracoscopic Lobectomy and Segmentectomy With Radical Lymph Node Dissection

Background. Reports of single-incision thoracoscopic lobectomy and segmentectomy are rare. In this article, we present our experience with single-incision thoracoscopic lobectomy and segmentectomy and radical mediastinal lymph node dissection. Methods. Nineteen patients with early-stage malignancy or benign lung disease were treated with single-incision thoracoscopic lobectomy and segmentectomy at our institution between November 2010 and May 2012. The surgical approach began with a single incision at the fifth or sixth intercostal space at the anterior axillary line. A 10-mm video camera and working instruments were used at the same time in this incision site throughout the surgery. The perioperative variables and outcomes were collected and analyzed retrospectively. Results. For the 19 patients included in the final analysis, 14 lobectomies and 5 segmentectomies were performed successfully without need for conversion. Among the 19 patients who underwent single-port video-assisted thoracoscopic surgery (VATS), 15 cases of cancer and 4 cases of benign pulmonary disease were noted. The mean operative time was 156 +/- 46 minutes, and the median number of lymph nodes retrieved was 22.9 +/- 9.8. Average blood loss was 38.4 +/- 25.9 mL. There were no deaths 30 days after surgery, and 2 cases of atelectasis were observed. Conclusions. Single-port VATS lobectomy and segmentectomy is safe and feasible for selected patients. (C) 2013 by The Society of Thoracic Surgeons