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Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS)

2019; Oxford University Press; Volume: 56; Issue: 2 Linguagem: Inglês

10.1093/ejcts/ezz133

1873-734X

Luca Bertolaccini, Hasan Fevzi Batırel, Alessandro Brunelli, Diego González-Rivas, Mahmoud Ismail, Antonio Martin Ucar, Calvin S.H. Ng, Marco Scarci, Alan Sihoe, Paula A. Ugalde, Firas Abu Akar, Benedetta Bedetti, Sergio Bolufer Nadal, Jury Brandolini, Pierfilippo Crucitti, Attila Enyedi, Hiran C. Fernando, József Furák, Javier Gallego-Poveda, Carlos Galvez-Munos, Ivo Hanke, Luis Ángel Hernández-Arenas, M. Janík, Peter Juhos, Lidia Libretti, Paolo Lucciarini, Paolo Macrí, Stefano Margaritora, Hamid Reza Mahoozi, Dania Nachira, Alessandro Pardolesi, Vadim Pischik, Dariusz Sagan, Hermien Schreurs, Dmitrii Sekhniaidze, Laura Socci, Davide Tosi, Akif Turna, Fernando Vannucci, Marcin Zieliński, Gaetano Rocco,

Tracheal and airway disorders

Abstract OBJECTIVES Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training. METHODS The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds. RESULTS Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be ≤4 cm. Agreement was reached on many points outlining the currently accepted definition of a UniVATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions. CONCLUSIONS The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is the establishment of a UniVATS section inside the ESTS databases.