La chirurgie par thoracoscopie vidéo-assistée uniportale : une évaluation clinique et oncologique à court terme

Authors: Bourdages-Pageau, Étienne
Advisor: Lacasse, YvesUgalde Figueroa, Paula Antonia
Abstract: Introduction. Over the last 30 years, the surgical treatment of early stage non small cell lung cancer has evolved rapidly. Previously performed by thoracotomy, lung resections are now usually performed by video-assisted thoracoscopic surgery (M-VATS). Recently, a new surgical approach has been used : uniportal video-assisted thoracoscopic surgery (U-VATS). Theoretical benefits of U-VATS consist of lessen pain and shortened post-operative recovery. However, some authors argue that U-VATS could be associated with greater risk of complications or lessen completeness of resection. The aim of both studies presented in this research was to evaluate if U-VATS is safe and feasible. Method. Two retrospective studies were conducted comparing consecutive patients who had surgery by either U-VATS or M-VATS. Clinical outcomes were evaluated in the first study and oncological outcomes were evaluated in the second study. Patients included in both studies had a lobectomy for early stage non small cell lung cancer. AllU-VATS lobectomies were performed by a single surgeon. In both studies, a propensity matched analysis was also conducted. Results. In the first study, compared to M-VATS, U-VATS was associated in the matched analysis with decreased intraoperative blood loss, duration of chest tube drainage and length of hospital stay. In the second study, M-VATS was not associated after matching with superior completeness of resection compared to U-VATS. Conclusion. U-VATS is safe and feasible for the treatment of early stage non small cell lung cancer. M-VATS is not superior to U-VATS in accomplishing complete oncologic resection thoracoscopically.
Document Type: Mémoire de maîtrise
Issue Date: 2019
Open Access Date: 2 August 2019
Grantor: Université Laval
Collection:Thèses et mémoires

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