Uniportal video-assisted thoracic surgery lobectomy in semiprone position: primary experience of 105 cases

Background: Uniportal video-assisted thoracic surgery (VATS) is becoming popular, and uniportal lobectomy in semiprone position was reported in 2014. This study aimed to investigate the feasibility and safety of uniportal VATS in semiprone position. Methods: From May 28, 2014 to October 19, 2015, we attempted uniportal VATS lobectomy in semiprone position in 105 cases. Forty-five patients were male, and 60 patients were female. Average age was 57.1 +/- 10.6 years (24-76 years). Perioperative parameters were documented. Results: There were two conversions to three-port lobectomy, one conversion to double-port lobectomy, and three conversions to thoracotomy. Among the patients who received uniportal VATS in semiprone position, mean operation duration was 137.4 +/- 47.8 minutes. Mean estimated blood loss was 60.7 +/- 102.7 mL. Mean time of drainage was 3.0 +/- 2.1 days, and postoperative length of stay averaged 4.9 +/- 2.3 days. In the cases of primary lung cancer, the mean number of nodal stations explored was 7.2 +/- 1.3, with a mean of 20.8 +/- 6.3 lymph nodes resected. As to the mediastinal lymph node specifically, a mean of 4.4 +/- 1.0 nodal stations were explored, and the number of resected mediastinal lymph nodes averaged 12.8 +/- 5.1. No perioperative death or major complication occurred. Conclusions: Uniportal VATS lobectomy in semiprone position is feasible and safe.