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.