Simultaneously thoracoscopic resection of lung cancer and anterior mediastinal lesions by video-assisted thoracoscopic surgery

Background: Video-assisted thoracoscopic surgery (VATS) has been widely applied to various types of pulmonary and mediastinal resections in recent years. However, there are still limited experiences of simultaneous thoracoscopic resection for lung cancer and mediastinal tumor. The aim of the study is to investigate the technical safety and feasibility of uniportal VATS for simultaneous resection for concurrent diseases of lung and anterior mediastinum and to compare with multiportal VATS. Methods: From June 2014 to December 2017, all patients who underwent simultaneously thoracoscopic resection for lung cancer and anterior mediastinal mass under uniportal or multiportal VATS via the same incision were retrospectively reviewed. Study cohort was divided according to surgical approach. Perioperative outcomes, including operative time, intraoperative blood loss, and postoperative hospitalization, were compared between uniportal and multiportal VATS groups. Results: A total of 51 patients were included in the study, of whom 33 patients had uniportal VATS and 18 patients had multiportal VATS. When compared to multiportal VATS group, uniportal VATS group had similar time of operation (149.1±49.0 vs . 159.1±58.5, P=0.518), intraoperative blood loss (103.0±184.3 vs . 105.6±80.2, P=0.956), and postoperative length of hospital stay (4.7±2.0 vs . 5.5±3.0, P=0.246). No operative deaths occurred in this study. Conclusions: Uniportal VATS for simultaneously thoracoscopic resection for lung cancer and anterior mediastinal disease is technically safe and feasible and has comparable operative parameters with multiportal VATS.