Long term outcome of Uniport versus Multiport Video-Assisted Thoracoscopic Lobectomy for Non-small Cell Lung Cancer: A Propensity-Matched Study

Abstract

Abstract Background:Uniportal Video-Assisted Thoracoscopic Surgery (U-VATS) has emerged as a feasible approach for treating non-small cell lung cancer (NSCLC). However, there is a lack of studies reporting the long-term survival outcomes of U-VATS lobectomy for NSCLC. Objective:This study aims to compare the perioperative outcomes and long-term survival of U-VATS lobectomy for NSCLC with multiportal VATS (M-VATS, involving two ports or more) lobectomy. Method: A total of 339 patients who underwent intentional VATS lobectomy for NSCLC between 2012 and 2017 were included in the analysis. Perioperative outcomes and long-term survival were evaluated. Propensity score matching was utilized to minimize baseline characteristic differences between the two groups. Results:Out of the total cases, 17 (5.01%) were converted to open thoracotomy. The conversion rates were 4.96% (7/141) in the U-VATS group and 5.05% (10/198) in the M-VATS group. A total of 322 consecutive patients underwent VATS lobectomy and mediastinal lymphadenectomy. After propensity matching, 106 pairs were obtained, consisting of 83 males and 129 females. Intraoperative bleeding volume, number of retrieved lymph nodes, explored nodal stations, drainage time and volume, and postoperative hospital stay were similar between the two groups. Both groups exhibited comparable morbidity and mortality rates. From the multivariable analysis, there was no significant difference observed in terms of overall survival (OS) and disease-free survival (DFS) between the two patient cohorts. Conclusions: U-VATS demonstrated comparable perioperative outcomes and long-term efficacy to M-VATS. However, further confirmation of these findings is required