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Page 4 of 8 Alexandre et al. Mini-invasive Surg 2020;4:35 I http://dx.doi.org/10.20517/2574-1225.2020.07

Ref.

Kwon et al. [11]
Handy et al. [10]
Nomori et al. [7]
Nakata et al. [23]
Nomori et al. [24]
Nagahiro et al. [6]
Bendixen et al. [8]
Andreetti et al. [9]
Van der Ploeg et al. [12]
74
22
RATS
17
13
75
33
10
49
28
103
227
n
VATS
9
11
18
70
33
103
201
28 × 3
Open
TH and
192 (64
128 MS)
RATS
4 + 1 ports
4 + 1 ports
incision
incision
incision
VATS
access incision
3 trocars, 6 cm
3 ports, 5-6 cm
incision of 4 cm
anterior access
anterior incision
2 ports, 6-10 cm
anterior incision
3 trocars, 5-6 cm
3 trocars, anterior
3 or 4 ports, access
3 ports, 4 cm anterior
2 ports, 7 cm anterior
3 ports, 4 cm anterior
axillary access incision
incision less than 5 cm
sparing
divided
sparing
sixth rib
ALT 12 cm
surgery; VC: vital capacity; MS: median sternotomy; TH: thoracotomy; QOL: quality of life
Description
rib resection
TH with muscle sparing
Open
cartilage but muscle sparing
AAT 20-25 cm
MS
PLT division of the muscles and two ribs
Muscles and one or two costal cartilages
ALT of 12 cm long with section of a costal
ALT of 16 cm incision with muscle and rib
Table 2. Comparative technical details of publications related to pain and repiratory recovery after lobectomy
ALT of 9-10 cm with muscle and rib sparing
PLT, one or two ribs resection and no muscle
PLT generally muscle sparing, resection of the
ALT of 20 cm long with muscle sparing and no
PLT 30-35 cm
(P < 0.05)
(P = 0.1966)
14 (P < 0.05)
(P = 0.0004)
Pain
week (P = 0.09)
5 (P = 0.51; 0.07; 0.26)
VATS = open (P = 0.08)
VATS = ALT the second
VATS > ALT (P = 0.000)
VATS > ALT the first week
VATS > PLT at POD 0, 1, 7,
MIS > open for acute pain
VATS > open for moderate
to severe pain (P < 0.0001)
MIS = open at POD 1, 3 and
MIS = open for chronic pain
0.014)
(P = 0.13)
QOL
Post op open < VATS for
and 0.03 at POD 7 and 14)
VATS = open for QLQ-C30
VATS = open for PaO 2 (P =
VATS > open for EQ5D (P =
social functioning (P < 0.05)
0.054), SatuO2 (P = 0.063),
physical functioning, role and
Post op VATS > open for pain
and general health (P < 0.05)
FVC (P = 0.1), FEV1 (P = 0.08)
VATS > open for PFR (P = 0.008
0.019)
< 0.05/P < 0.001)
PLT: postero-lateral thoracotomy; MIS: minimally invasive surgery; PPOD: post operative day; PFR: peak flow rate; ALT: anterior limited thoracotomy; AAT: anteroaxillary thoracotomy; 6MWT: 6 min
walking test; FEV1: forced expiratory volume in 1 second; EQ5D: euroQol 5 dimensions; QLQ-C30: 30 item quality of life questionnaire; VATS: video-assisted thoracoscopic surgery; RATS: robotic assisted
and 6MWT (P = 0.14)
and 6MWT (P = 0.000)
Respiratory function
VATS > ALT at one week for
0.07) and 6MWT (P = 0.06)
< 0.05) and 6MWT (P < 0.01)
PLT < ALT/AAT/VATS for VC (P
VATS > PLT for FVC (P = 0.011),
AAT < ALT/VATS for 6MWT (P
VATS = open for FEV1 (P = 0.17)
respiratory muscle strength (P =
VATS > ALT for FEV1 (P = 0.028)
for FEV1 (P = 0.039) and VC (P =