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Page 4 of 8 Sathiamurthy et al. Mini-invasive Surg 2020;4:38 I http://dx.doi.org/10.20517/2574-1225.2020.25

Table 2. U-VATS procedural analysis
Operative Blood loss Lymph Conversion to open Drain duration Hospital stay
Procedures Number time (min) (mL) nodes thoracotomy (days) (days)
Biopsy 11 45 50 ± 10 - - 1.0 ± 0.8 3 ± 1.0
Hemothorax evacuation + 11 85 350 ± 125 - 2 (18%) 3.5 ± 1.7 7 ± 3.2
washout
Bullectomy + pleurodesis 34 80 55 ± 10 - - 3 ± 1.0 3 ± 1.4
Decortication 25 126 350 ± 110 - 7 (28%) 5 ± 2.5 7 ± 4.2
Wedge resection 6 60 50 ± 11 - - 1.5 ± 0.9 3 ± 0.8
Segmentectomy 9 170 100 ± 21 4 - 2.4 ± 1 3 ± 1.1
Lobectomy
Aspergilloma 9 244 315 ± 120 4 1 (11%) 6.8 ± 4 7 ± 3.9
NSCLC 13 201 120 ± 53 20 2 (15%) 3.5 ± 2.2 4 ± 1.5
Lung Sequester 2 180 65 - - 2.0 3
Metastastectomy 4 120 70 ± 2 - - 2.1 3 ± 1.1
Bronchoplasty 2 320 250 - - 4.0 5
Thymectomy 25 147 100 ± 22 3 3 (12%) 2.1 ± 1.1 3 ± 1.8
Diaphragmatic plication 6 130 80 ± 4 - 1 (16%) 2.8 ± 1.9 4 ± 2.1
Ectopic thyroidectomy 3 100 60 ± 12 - - 2 3 ± 1.4
Ectopic parathyroidectomy 3 120 20 ± 3 2 3 ± 1.2
Mediastinal mass excision 5 115 100 ± 18 - 1 (20%) 1.5 ± 0.7 3 ± 2.2
(non-thymus)
Pericardial window 2 30 10 - - 3 6
Chest wall resection 1 105 100 - - 2 3
Total 169 17 (10%)

Categorical variables were reported as frequency counts and percentages. Continuous variables were reported as means and standard
deviation. NSCLC: non-small cell lung cancer; U-VATS: uniportal video assisted thoracoscopic surgery

Table 3. Comparison of U-VATS procedures performed in the 1st and 2nd year

Surgery time Lymph Conversion to Drain duration Hospital stay
Procedures Number Blood loss (mL)
(min) nodes open thoracotomy (days) (days)
Year 1 2 1 2 1 2 1 2 1 2 1 2 1 2
Bullectomy + 18 16 90 ± 22 80 ± 12 52 ± 24 58 ± 20 - - - - 3.0 ± 1.0 3.0 ± 0.9 3 ± 1.0 3.0 ± 0.9
pleurodesis
Lobectomy
Aspergilloma 3 6 260 ± 50 236 ± 35 380 ± 95 283 ± 102 2 2 1 - 7.6 ± 4.0 6.4 ± 4.3 7.6 ± 4.0 6.4 ± 4.3
NSCLC 5 8 219 ± 47 190 ± 25 130 ± 44 114 ± 31 19 ± 3 21 ± 5 2 - 4.4 ± 1.9 3.2 ± 0.4 4.8 ± 1.8 3.5 ± 0.5
Lung sequester 1 1 170 190 60 70 - - - - 2 3 2 3
Thymectomy 11 14 170 ± 33 129 ± 25 110 ± 15 92 ± 22 - 3 3 - 2.5 ± 1.0 1.8 ± 1.0 3.3 ± 2.0 2.8 ± 1.0
Categorical variables were reported as frequency counts and percentages. Continuous variables were reported as mean and standard
deviation. There was no significant difference (P > 0.05) for the variables between the 1st and 2nd year for all procedures. NSCLC: non-
small cell lung cancer; U-VATS: uniportal video assisted thoracoscopic surgery

Only 13 cases of lobectomies for NSCLC were performed by U-VATS in throughout the study duration
of two years. The average time taken was 201 min and this includes complete lymphadenectomy of
stations 2, 4, 7, 8 and 9 on the right, and 5, 6, 7, 8 and 9 on the left. In the first year of performing U-VATS
lobectomies, the mean time taken was 219 min and this reduced to 190 min in the second year with no
significant difference between them. The lymph node yield was at the average of 20 lymph nodes with no
significant difference between the lobectomies performed in the first and second year [Table 3].

DISCUSSION
Thoracoscopic surgery has been performed via multiple access ports in the thorax since the 1990s. Many
[3-7]
publications are available to support the efficacy of this approach . The recently concluded randomised
control trial, Video Assisted Thoracoscopic Lobectomy Versus Conventional Open Lobectomy for Lung
Cancer (VIOLET) study confirmed that VATS is not inferior to open thoracotomy in the oncological
outcomes of NSCLC resection and provides better post-operative pain control. Since 2003, Prof Gaetano