Perioperative Outcomes of Uniportal Versus Three-port Video-assisted Thoracoscopic Surgery in Lung Cancer Patients Aged ≥75 years old: A Cohort Study

Abstract

Abstract Background Increasing attention has been raised on the surgical option for lung cancer patients aged ≥75 years, however, few studies have focused on whether uniportal video-assisted thoracoscopic surgery (VATS) is safe and feasible for these patients. This study aimed to evaluate short-term results of uniportal versus three-port VATS for the treatment of lung cancer patients aged ≥75 years. Methods We retrospectively evaluated 582 lung cancer patients (≥75 years) who underwent uniportal or three-port VATS from August 2007 to August 2021 based on the Western China Lung Cancer Database. The baseline and perioperative outcomes between uniportal and three-port VATS were compared in the whole cohort (WC) and the patients undergoing lobectomy (lobectomy cohort, LC) respectively. ResultsIntraoperative blood loss was significantly less in the uniportal than three-port LC (50 mL vs. 83 mL, P=0.007) and was also relatively less in the uniportal than three-port WC (50 mL vs. 75 mL, P=0.05). In addition, in WC and LC, there were no significant differences between uniportal and three-port cohorts in terms of operation time, the rate of conversion to thoracotomy during surgery, nodal treatments (dissection or sampling or not), the overall number of lymph nodes and stations dissected, postoperative complications, volume and duration of postoperative thoracic drainage, hospital stay after operation and hospitalization expenses (P>0.05). Conclusions There were no significant differences in short-term outcomes between uniportal and three-port VATS for lung cancer patients (≥75 years), except significantly less intraoperative blood loss was found in uniportal LC (P<0.05). It is reasonable to indicate that uniportal VATS is a safe, feasible and effective operation procedure for lung cancer patients aged ≥75 years.