Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial
Abstract Background Uniportal video‐assisted thoracoscopic surgery (VATS) lobectomy has become a common approach for the treatment of early stage lung cancer. Here, we aimed to establish whether the length of uniportal incision could affect postoperative pain and surgical outcomes in consecutive pat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13291 |
| _version_ | 1828837791675449344 |
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| author | Cecilia Menna Camilla Poggi Claudio Andreetti Giulio Maurizi Anna Maria Ciccone Antonio D'Andrilli Camilla Vanni Anna Rita Vestri Alfonso Fiorelli Mario Santini Federico Venuta Erino Angelo Rendina Mohsen Ibrahim |
| author_facet | Cecilia Menna Camilla Poggi Claudio Andreetti Giulio Maurizi Anna Maria Ciccone Antonio D'Andrilli Camilla Vanni Anna Rita Vestri Alfonso Fiorelli Mario Santini Federico Venuta Erino Angelo Rendina Mohsen Ibrahim |
| author_sort | Cecilia Menna |
| collection | DOAJ |
| description | Abstract Background Uniportal video‐assisted thoracoscopic surgery (VATS) lobectomy has become a common approach for the treatment of early stage lung cancer. Here, we aimed to establish whether the length of uniportal incision could affect postoperative pain and surgical outcomes in consecutive patients undergoing uniportal VATS lobectomy for early stage lung cancer. Methods This was a unicenter Randomized Control Trial (NCT 03218098). Consecutive patients undergoing uniportal VATS lobectomy for Stage I lung cancer were randomly assigned to a Small Incision group or Long Incision group in 1:1 ratio based on whether patients received a 4 cm or 8 cm incision. The endpoints were to compare the intergroup difference regarding (i) postoperative pain measured by brief pain inventory (BPI) questionnaire (first endpoint); (ii) operative time; (iii) length of chest drainage; (iv) length of hospital stay; (v) postoperative complications; and (vi) pulmonary functional status (secondary endpoints). Results A total of 48 patients were eligible for the study. Four patients were excluded; the study population included 44 patients: 23 within the Small Incision group, and 21 within the Long Incision group. The 11 BPI scores between the two groups showed no significant difference. Small Incision group presented higher operative time than Long Incision group (138.69 vs. 112.14 minutes; P = 0.0001) while no significant differences were found regarding length of hospital stay (P = 0.95); respiratory complications (P = 0.92); FEV1% (P = 0.63), and 6‐Minute Walking Test (P = 0.77). Conclusions A larger incision for uniportal VATS lobectomy significantly reduced the operative time due to better exposure of the anatomical structures without increasing postoperative pain or affecting the surgical outcome. Key points A larger incision for uniportal VATS lobectomy significantly reduced the operative time due to better exposure of the anatomical structures without increasing postoperative pain or affecting the surgical outcome. To perform a larger incision could be a valuable strategy, particularly in nonexpert hands or when the patient's anatomy or tumor size make exposure of anatomic structures through smaller incisions difficult. |
| first_indexed | 2024-12-12T18:49:29Z |
| format | Article |
| id | doaj.art-3ead2b3d72094ceeaf436738fee37805 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-12T18:49:29Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-3ead2b3d72094ceeaf436738fee378052022-12-22T00:15:25ZengWileyThoracic Cancer1759-77061759-77142020-07-011171765177210.1111/1759-7714.13291Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trialCecilia Menna0Camilla Poggi1Claudio Andreetti2Giulio Maurizi3Anna Maria Ciccone4Antonio D'Andrilli5Camilla Vanni6Anna Rita Vestri7Alfonso Fiorelli8Mario Santini9Federico Venuta10Erino Angelo Rendina11Mohsen Ibrahim12Division of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Policlinico Umberto I University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDepartment of Public Health and Infectious Disease University of Rome “Sapienza” Rome ItalyThoracic surgery Unit University of Campania Luigi Vanvitelli Naples ItalyThoracic surgery Unit University of Campania Luigi Vanvitelli Naples ItalyDivision of Thoracic Surgery, Policlinico Umberto I University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyDivision of Thoracic Surgery, Sant'Andrea Hospital University of Rome “Sapienza” Rome ItalyAbstract Background Uniportal video‐assisted thoracoscopic surgery (VATS) lobectomy has become a common approach for the treatment of early stage lung cancer. Here, we aimed to establish whether the length of uniportal incision could affect postoperative pain and surgical outcomes in consecutive patients undergoing uniportal VATS lobectomy for early stage lung cancer. Methods This was a unicenter Randomized Control Trial (NCT 03218098). Consecutive patients undergoing uniportal VATS lobectomy for Stage I lung cancer were randomly assigned to a Small Incision group or Long Incision group in 1:1 ratio based on whether patients received a 4 cm or 8 cm incision. The endpoints were to compare the intergroup difference regarding (i) postoperative pain measured by brief pain inventory (BPI) questionnaire (first endpoint); (ii) operative time; (iii) length of chest drainage; (iv) length of hospital stay; (v) postoperative complications; and (vi) pulmonary functional status (secondary endpoints). Results A total of 48 patients were eligible for the study. Four patients were excluded; the study population included 44 patients: 23 within the Small Incision group, and 21 within the Long Incision group. The 11 BPI scores between the two groups showed no significant difference. Small Incision group presented higher operative time than Long Incision group (138.69 vs. 112.14 minutes; P = 0.0001) while no significant differences were found regarding length of hospital stay (P = 0.95); respiratory complications (P = 0.92); FEV1% (P = 0.63), and 6‐Minute Walking Test (P = 0.77). Conclusions A larger incision for uniportal VATS lobectomy significantly reduced the operative time due to better exposure of the anatomical structures without increasing postoperative pain or affecting the surgical outcome. Key points A larger incision for uniportal VATS lobectomy significantly reduced the operative time due to better exposure of the anatomical structures without increasing postoperative pain or affecting the surgical outcome. To perform a larger incision could be a valuable strategy, particularly in nonexpert hands or when the patient's anatomy or tumor size make exposure of anatomic structures through smaller incisions difficult.https://doi.org/10.1111/1759-7714.13291Lobectomypost‐operative painuniportal video‐assisted thoracoscopic surgery |
| spellingShingle | Cecilia Menna Camilla Poggi Claudio Andreetti Giulio Maurizi Anna Maria Ciccone Antonio D'Andrilli Camilla Vanni Anna Rita Vestri Alfonso Fiorelli Mario Santini Federico Venuta Erino Angelo Rendina Mohsen Ibrahim Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial Thoracic Cancer Lobectomy post‐operative pain uniportal video‐assisted thoracoscopic surgery |
| title | Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial |
| title_full | Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial |
| title_fullStr | Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial |
| title_full_unstemmed | Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial |
| title_short | Does the length of uniportal video‐assisted thoracoscopic lobectomy affect postoperative pain? Results of a randomized controlled trial |
| title_sort | does the length of uniportal video assisted thoracoscopic lobectomy affect postoperative pain results of a randomized controlled trial |
| topic | Lobectomy post‐operative pain uniportal video‐assisted thoracoscopic surgery |
| url | https://doi.org/10.1111/1759-7714.13291 |
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