Comparative clinical experience of subcostal VATS versus conventional uniportal lateral VATS approach

Volkan Kösek; Eyad Al Masri; Katina Nikolova; Björn Ellger; Shadi Wais; Bassam Redwan

doi:10.4103/jmas.jmas_26_24

Comparative clinical experience of subcostal VATS versus conventional uniportal lateral VATS approach

J Minim Access Surg. 2024 Jul 1;20(3):326-333. doi: 10.4103/jmas.jmas_26_24. Epub 2024 Jul 24.

Authors

Volkan Kösek^{1

2}, Eyad Al Masri¹, Katina Nikolova¹, Björn Ellger³, Shadi Wais⁴, Bassam Redwan^{1

2}

Affiliations

¹ Department of Thoracic Surgery, Klinik am Park, Klinikum Westfalen, Lünen, Germany.
² Faculty of Medicine, University of Witten/Herdecke, Witten, Germany.
³ Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Knappschaftskrankenhaus Dortmund, Klinikum Westfalen, Dortmund, Germany.
⁴ Department of General Visceral, Thoracic and Endocrine Surgery, Augusta Hospital, Düsseldorf, Germany.

Abstract

Introduction: The present study reports the first clinical experience with subcostal uniportal VATS (suVATS) compared with the conventional lateral uniportal VATS (luVATS) approach.

Patients and methods: All patients who underwent suVATS between January 2019 and April 2020 were included. Patients who had undergone luVATS for similar indications were included as the control group. The data were prospectively and retrospectively analysed.

Results: The suVATS group included 38 patients with a mean age of 61 (30-83) years. The luVATS group included 33 patients (mean age, 69 years; range: 46-89 years). An intercostal block was performed intraoperatively in the luVATS group. Local infiltration under anaesthesia was performed around the incision in the suVATS group. The duration of the surgery was significantly longer in the suVATS group. However, the chest tube treatment and hospital stay duration were significantly shorter in the suVATS group. The routinely recorded Visual Analogue Scale scores on the first post-operative day and the day of discharge were significantly lower in the suVATS group.

Conclusion: Subcostal uniportal VATS enables a shorter drainage treatment duration and hospital stay and significantly reduces post-operative pain. Thus, a faster patient recovery can be achieved.