Application of single-microport assisted micro-uni-port thoracoscopy surgery in up-lobectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Pu , LI Ziliang , LIU Huan , GUO Kang , CHEN Juan , SHANG Jiangli , DENG Sanming , CUI Kai , LI Wenhai ,  WANG Wuping , LI Xiaofei

Thoracic Surgery Department of Xi’an International Medical Center Hospital, Xi’an, 710100, P. R. China;

Corresponding?author：

WANG Wuping, Email: wwp._8@163.com

Keywords：

Single-microport assisted micro-uni-port thoracoscopy surgery; uniportal video assisted thoracic surgery; radical resection of lung cancer; minimally invasive

DOI：

10.7507/1007-4848.202407066

Video：

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Objective To analyze the technical essentials of single-microport assisted micro-uni-port thoracoscopic surgery, and to investigate its surgical efficacy and promotional value. Methods Clinical data of patients who consecutively underwent radical upper lobectomy in the Department of Thoracic Surgery of Xi'an International Medical Center Hospital from March 2023 to June 2024 were retrospectively analyzed. According to the surgical approach, patients were divided into two groups: the single-microport assisted group (underwent upper lobectomy via single-microport assisted micro-uni-port thoracoscopy) and the traditional uniportal group (underwent traditional uniportal thoracoscopic lobectomy). Clinical outcomes were compared between the two groups. Results A total of 62 patients were enrolled. There were 30 patients in the single-microport assisted group, with a mean age of (57.4±10.8) years, and 32 patients in the traditional uniportal thoracoscopic group, with a mean age of (57.6±8.7) years. The baseline data were comparable between the two groups. All patients in both groups successfully underwent minimally invasive surgery without conversion to thoracotomy. The operative time in the single-microport assisted group was significantly shorter than that in the traditional uniportal group [(146.03±30.79) min vs. (171.41±36.41) min, P=0.004]. However, there were no statistically significant differences between the two groups in intraoperative blood loss, number of dissected lymph nodes, duration of chest tube drainage, postoperative pain score, postoperative hospital stay, hospitalization cost, or incidence of postoperative complications (all P>0.05). Conclusion Single-microport assisted micro-uni-port thoracoscopic surgery for upper lobectomy can maximally integrate the advantages of three-port and uni-port VATS while effectively avoiding their disadvantages. It significantly shortens the operative time without increasing postoperative pain or complications, and represents a more minimally invasive, safer, and more convenient surgical approach.

Citation： ZHANG Pu, LI Ziliang, LIU Huan, GUO Kang, CHEN Juan, SHANG Jiangli, DENG Sanming, CUI Kai, LI Wenhai, WANG Wuping, LI Xiaofei. Application of single-microport assisted micro-uni-port thoracoscopy surgery in up-lobectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2026, 33(8): 1240-1245. doi: 10.7507/1007-4848.202407066 Copy

1.	Gonzalez-Rivas D, Delgado M, Fieira E, et al. Left lower sleeve lobectomy by uniportal video-assisted thoracoscopic approach[J]. Interact Cardiovasc Thorac Surg, 2014, 18(2): 237-239.
2.	Gonzalez-Rivas D, Fieira E, de la Torre M, et al. Bronchovascular right upper lobe reconstruction by uniportal video-assisted thoracoscopic surgery[J]. J Thorac Dis, 2014, 6(6): 861-863.
3.	Gonzalez-Rivas D, Delgado M, Fieira E, et al. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer[J]. Ann Cardiothorac Surg, 2014, 3(2): E2.
4.	Gonzalez-Rivas D, Mendez L, Delgado M, et al. Uniportal video-assisted thoracoscopic anatomic segmentectomy[J]. J Thorac Dis, 2013, 5(Suppl 3): S226-S233.
5.	謝冬, 陳昶, 姜格寧. 肺癌外科手術切口的演變與發展趨勢[J]. 中國肺癌雜志, 2016, 19(6): 343-346.Xie D, Chen C, Giang GL. Evolution and development trend of lung cancer surgical incision[J]. Chin J Lung Cancer, 2016, 19(6): 343-346.
6.	Tomaszek SC, Cassivi SD, Shen KR, et al. Clinical outcomes of video-assisted thoracoscopic lobectomy[J]. Mayo Clin Proc, 2009, 84(6): 509-513.
7.	Luh SP, Liu HP. Video-assisted thoracic surgery—the past, present status and the future[J]. J Zhejiang Univ Sci B, 2006, 7(2): 118-128.
8.	Xiang Z, Wu B, Zhang X, et al. Uniportal versus multiportal video-assisted thoracoscopic segmentectomy for non-small cell lung cancer: a systematic review and meta-analysis[J]. Surg Today, 2023, 53(3): 293-305.
9.	Tulinsky L, Kepi?ová M, Ihnát P, et al. Radicality and safety of mediastinal lymphadenectomy in lung resection: A comparative analysis of uniportal thoracoscopic, multiportal thoracoscopic, and thoracotomy approaches[J]. Surg Endosc, 2023, 37(12): 9208-9216.
10.	Hu CG, Zheng K, Liu GH, et al. Efectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer: a retrospective cohort study[J]. Gen Thorac Cardiovasc Surg, 2021, 69: 318-325.
11.	Wang Y, Wang Z, Yao F. The safety and feasibility of three-dimension single-port video-assisted thoracoscopic surgery for the treatment of early-stage lung cancer[J]. Thorac Dis, 2020, 12(12): 7257-7265.
12.	Liu C, Ran R, Luo L, et al. The three steps method for uniportal video-assisted thoracoscopic right upper lobectomy[J]. J Cardiothorac Surg, 2023, 18(1): 12.
13.	Bourdages-Pageau E, Vieira A, Lacasse Y, et al. Outcomes of uniportal vs multiportal video-assisted thoracoscopic lobectomy[J]. Semin Thorac Cardiovasc Surg, 2020, 32(1): 145-151.
14.	車國衛, 劉倫旭. 單孔電視胸腔鏡手術臨床應用的現狀與進展[J]. 中國胸心血管外科臨床雜志, 2012, 19(2): 181-184.Che GW, Liu LX. Advancement and progress of single-port video-assisted thoracoscopic surgery in the treatment of thoracic diseases[J]. Chin Clin Thorac Cardiovasc Surg, 2012, 19(2): 181-184.
15.	劉高遠, 甄志鵬, 李永輝. 胸腔鏡肺癌根治術后胸腔引流管管理的研究進展[J]. 中國現代醫學雜志, 2019, 29(12): 48-52.Liu GY, Zhen ZP, Li YH. Progress of thoracic drainage tube management after lung cancer with thoracoscopic radical surgery[J]. Chin J Mod Med, 2019, 29(12): 48-52.
16.	Yang SM, Kuo SW. Incision for uniportal VATS: above the rib or intercostal space?[J] Ann Thorac Surg, 2016, 101(5): 2020-2021.
17.	Xu Y, Luo J, Ge QY, et al. Safety and feasibility of a novel chest tube placement in uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer[J]. Thorac Cancer, 2023, 14(26): 2648-2656.
18.	Yang Y, Li J, Cheng X, et al. Export priority technique for uni-portal thoracoscopic left upper lobectomy[J]. J Cardiothorac Surg, 2024, 19(1): 275.

1. Gonzalez-Rivas D, Delgado M, Fieira E, et al. Left lower sleeve lobectomy by uniportal video-assisted thoracoscopic approach[J]. Interact Cardiovasc Thorac Surg, 2014, 18(2): 237-239.
2. Gonzalez-Rivas D, Fieira E, de la Torre M, et al. Bronchovascular right upper lobe reconstruction by uniportal video-assisted thoracoscopic surgery[J]. J Thorac Dis, 2014, 6(6): 861-863.
3. Gonzalez-Rivas D, Delgado M, Fieira E, et al. Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer[J]. Ann Cardiothorac Surg, 2014, 3(2): E2.
4. Gonzalez-Rivas D, Mendez L, Delgado M, et al. Uniportal video-assisted thoracoscopic anatomic segmentectomy[J]. J Thorac Dis, 2013, 5(Suppl 3): S226-S233.
5. 謝冬, 陳昶, 姜格寧. 肺癌外科手術切口的演變與發展趨勢[J]. 中國肺癌雜志, 2016, 19(6): 343-346.Xie D, Chen C, Giang GL. Evolution and development trend of lung cancer surgical incision[J]. Chin J Lung Cancer, 2016, 19(6): 343-346.
6. Tomaszek SC, Cassivi SD, Shen KR, et al. Clinical outcomes of video-assisted thoracoscopic lobectomy[J]. Mayo Clin Proc, 2009, 84(6): 509-513.
7. Luh SP, Liu HP. Video-assisted thoracic surgery—the past, present status and the future[J]. J Zhejiang Univ Sci B, 2006, 7(2): 118-128.
8. Xiang Z, Wu B, Zhang X, et al. Uniportal versus multiportal video-assisted thoracoscopic segmentectomy for non-small cell lung cancer: a systematic review and meta-analysis[J]. Surg Today, 2023, 53(3): 293-305.
9. Tulinsky L, Kepi?ová M, Ihnát P, et al. Radicality and safety of mediastinal lymphadenectomy in lung resection: A comparative analysis of uniportal thoracoscopic, multiportal thoracoscopic, and thoracotomy approaches[J]. Surg Endosc, 2023, 37(12): 9208-9216.
10. Hu CG, Zheng K, Liu GH, et al. Efectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer: a retrospective cohort study[J]. Gen Thorac Cardiovasc Surg, 2021, 69: 318-325.
11. Wang Y, Wang Z, Yao F. The safety and feasibility of three-dimension single-port video-assisted thoracoscopic surgery for the treatment of early-stage lung cancer[J]. Thorac Dis, 2020, 12(12): 7257-7265.
12. Liu C, Ran R, Luo L, et al. The three steps method for uniportal video-assisted thoracoscopic right upper lobectomy[J]. J Cardiothorac Surg, 2023, 18(1): 12.
13. Bourdages-Pageau E, Vieira A, Lacasse Y, et al. Outcomes of uniportal vs multiportal video-assisted thoracoscopic lobectomy[J]. Semin Thorac Cardiovasc Surg, 2020, 32(1): 145-151.
14. 車國衛, 劉倫旭. 單孔電視胸腔鏡手術臨床應用的現狀與進展[J]. 中國胸心血管外科臨床雜志, 2012, 19(2): 181-184.Che GW, Liu LX. Advancement and progress of single-port video-assisted thoracoscopic surgery in the treatment of thoracic diseases[J]. Chin Clin Thorac Cardiovasc Surg, 2012, 19(2): 181-184.
15. 劉高遠, 甄志鵬, 李永輝. 胸腔鏡肺癌根治術后胸腔引流管管理的研究進展[J]. 中國現代醫學雜志, 2019, 29(12): 48-52.Liu GY, Zhen ZP, Li YH. Progress of thoracic drainage tube management after lung cancer with thoracoscopic radical surgery[J]. Chin J Mod Med, 2019, 29(12): 48-52.
16. Yang SM, Kuo SW. Incision for uniportal VATS: above the rib or intercostal space?[J] Ann Thorac Surg, 2016, 101(5): 2020-2021.
17. Xu Y, Luo J, Ge QY, et al. Safety and feasibility of a novel chest tube placement in uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer[J]. Thorac Cancer, 2023, 14(26): 2648-2656.
18. Yang Y, Li J, Cheng X, et al. Export priority technique for uni-portal thoracoscopic left upper lobectomy[J]. J Cardiothorac Surg, 2024, 19(1): 275.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of single-microport assisted micro-uni-port thoracoscopy surgery in up-lobectomy

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