当院における単孔式胸腔鏡手術の周術期成績
【背景】単孔式VATS（uVATS）は徐々に本邦で広まっている低侵襲アプローチであるが，その周術期成績に関する報告はまだ少ない．【方法】2017年4月～2024年6月までに当院で肺腫瘍に対し解剖学的肺切除を受けた637例（uVATS群390例，多孔式VATS群247例）を対象に周術期成績を比較した．さらに，原発性肺癌に対し縦隔リンパ節郭清を伴う肺葉切除を施行した337例，および区域切除例220例について，傾向スコアマッチング前後で比較した．【結果】全ての比較においてuVATS群で有意に手術時間，ドレナージ期間が短かった．出血量，開胸移行，血管損傷，郭清リンパ節個数，術後合併症に差はなかった．術...
Saved in:
| Published in | 日本呼吸器外科学会雑誌 Vol. 39; no. 5; pp. 390 - 398 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本呼吸器外科学会
15.07.2025
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.39.390 |
Cover
| Abstract | 【背景】単孔式VATS（uVATS）は徐々に本邦で広まっている低侵襲アプローチであるが，その周術期成績に関する報告はまだ少ない．【方法】2017年4月～2024年6月までに当院で肺腫瘍に対し解剖学的肺切除を受けた637例（uVATS群390例，多孔式VATS群247例）を対象に周術期成績を比較した．さらに，原発性肺癌に対し縦隔リンパ節郭清を伴う肺葉切除を施行した337例，および区域切除例220例について，傾向スコアマッチング前後で比較した．【結果】全ての比較においてuVATS群で有意に手術時間，ドレナージ期間が短かった．出血量，開胸移行，血管損傷，郭清リンパ節個数，術後合併症に差はなかった．術後在院日数は傾向スコアマッチング後の区域切除例を除きuVATS群で有意な短縮を認めた．両群とも手術関連死亡はなかった．【結語】uVATSの周術期成績は良好であり，安全に施行可能である． |
|---|---|
| AbstractList | 【背景】単孔式VATS（uVATS）は徐々に本邦で広まっている低侵襲アプローチであるが，その周術期成績に関する報告はまだ少ない．【方法】2017年4月～2024年6月までに当院で肺腫瘍に対し解剖学的肺切除を受けた637例（uVATS群390例，多孔式VATS群247例）を対象に周術期成績を比較した．さらに，原発性肺癌に対し縦隔リンパ節郭清を伴う肺葉切除を施行した337例，および区域切除例220例について，傾向スコアマッチング前後で比較した．【結果】全ての比較においてuVATS群で有意に手術時間，ドレナージ期間が短かった．出血量，開胸移行，血管損傷，郭清リンパ節個数，術後合併症に差はなかった．術後在院日数は傾向スコアマッチング後の区域切除例を除きuVATS群で有意な短縮を認めた．両群とも手術関連死亡はなかった．【結語】uVATSの周術期成績は良好であり，安全に施行可能である． |
| Author | 沼尻 一樹 井田 晃頌 井貝 仁 新居 和人 上吉原 光宏 |
| Author_xml | – sequence: 1 fullname: 新居 和人 organization: 前橋赤十字病院呼吸器外科 – sequence: 1 fullname: 上吉原 光宏 organization: 前橋赤十字病院呼吸器外科 – sequence: 1 fullname: 井田 晃頌 organization: 前橋赤十字病院呼吸器外科 – sequence: 1 fullname: 沼尻 一樹 organization: 前橋赤十字病院呼吸器外科 – sequence: 1 fullname: 井貝 仁 organization: 前橋赤十字病院呼吸器外科 |
| BookMark | eNo9UE1Lw0AUXKSCsfbqv0jdj2yyD7yU4hcUvPQeNttNbahVknrwGEVQS6mlPSgIUk-C6LkH9c-ExPRfGLEIj5kHbxhm3joq9U56GqFNgqsUgG8FUkVnYbvKoBi8ggwiBDEtwkUJGRgImBgsvoYqUdTxMKaUMsFsA22nn5PFw3MSvybxbRKPk4tBOrxP36bpxyi_nOdX08Volt0M8tkkid_T8UuxZI9P2fXd9_xrA636shvpypLLqLm706zvm43DvYN6rWEGhHBpekA9y4IWV16RQQopbNDKIloDt7ntgK-1lmBr2xFUSYWFwj5vUQoC-47Fyqj2ZxtEfdnW7mnYOZbhuSvDfkd1tbvs7jJw-S8UD_i_qSMZFgL2A_8bbLQ |
| ContentType | Journal Article |
| Copyright | 2025 一般社団法人 日本呼吸器外科学会 |
| Copyright_xml | – notice: 2025 一般社団法人 日本呼吸器外科学会 |
| DOI | 10.2995/jacsurg.39.390 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 1881-4158 |
| EndPage | 398 |
| ExternalDocumentID | article_jacsurg_39_5_39_390_article_char_ja |
| GroupedDBID | ABJNI ACGFS ALMA_UNASSIGNED_HOLDINGS JSF KQ8 OK1 RJT |
| ID | FETCH-LOGICAL-j115a-b92b449d5cb945a8a869ec41ee9565679feeea96e6782cac08c0f5d22980f743 |
| ISSN | 0919-0945 |
| IngestDate | Wed Sep 03 06:30:45 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 5 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j115a-b92b449d5cb945a8a869ec41ee9565679feeea96e6782cac08c0f5d22980f743 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jacsurg/39/5/39_390/_article/-char/ja |
| PageCount | 9 |
| ParticipantIDs | jstage_primary_article_jacsurg_39_5_39_390_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2025/07/15 |
| PublicationDateYYYYMMDD | 2025-07-15 |
| PublicationDate_xml | – month: 07 year: 2025 text: 2025/07/15 day: 15 |
| PublicationDecade | 2020 |
| PublicationTitle | 日本呼吸器外科学会雑誌 |
| PublicationTitleAlternate | 日呼外会誌 |
| PublicationYear | 2025 |
| Publisher | 日本呼吸器外科学会 |
| Publisher_xml | – name: 日本呼吸器外科学会 |
| References | 22. Matsuura N, Igai H, Ohsawa F, Yazawa T, Kamiyoshihara M. Uniport vs. multiport video-assisted thoracoscopic surgery for anatomical lung resection-which is less invasive? J Thorac Dis 2021; 13: 244-51. 12. Wu CY, Chen YY, Chang CC, Yen YT, Lai WW, Huang WL, et al. Single-port thoracoscopic anatomic resection for chronic inflammatory lung disease. BMC Surg 2021; 21: 244. 7. Xiang Z, Wu B, Zhang X, Wei Y, Xu J, Zhang W. Uniportal versus multiportal video-assisted thoracoscopic segmentectomy for non-small cell lung cancer: a systematic review and meta-analysis. Surg Today 2023; 53: 293-305. 1. Rocco G, Martin-Ucar A, Passera E. Uniportal VATS Wedge Pulmonary Resections. Ann Thorac Surg 2004; 77: 726-8. 18. Lim E, Harris RA, Batchelor T, Casali G, Krishnadas R, Begum S, et al. Outcomes of single- versus multi-port video-assisted thoracoscopic surgery: Data from a multicenter randomized controlled trial of video-assisted thoracoscopic surgery versus thoracotomy for lung cancer. JTCVS Open 2024; 19: 296-308. 2. Gonzalez D, Paradela M, Garcia J, Dela Torre M. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg 2011; 12: 514-5. 15. Ruan Y, Cao W, Xue H, You M, Zhao Z. Long-term outcome of uniport vs. multiport video-assisted thoracoscopic lobectomy for lung cancer. Sci Rep 2024; 14: 5316. 11. Sano Y, Okazaki M, Shigematsu H, Yamashita N, Sugimoto R, Sakao N, et al. Quality of life after partial lung resection with uniportal versus 3-port video-assisted thoracoscopic surgery: a prospective randomized controlled study. Surg Today 2021; 51: 1755-63. 13. Igai H, Kamiyoshihara M. Uniportal thoracoscopic fissureless right lower lobectomy using the suction device trick. Multimed Man Cardiothorac Surg. [Internet]. 2019 Dec. 20 [cited 2024 Dec. 19]; 2019: [about 1p.]. Available from: https://mmcts.org/tutorial/1370. 17. Nii K, Igai H, Numajiri K, Ohsawa F, Kamiyoshihara M. Uniportal thoracoscopic mediastinal lymphadenectomy using appropriate surgical steps. J Thorac Dis 2024; 16: 321-32. 14. Gonzalez-Rivas D, Sihoe ADL. Important Technical Details During Uniportal Video-Assisted Thoracoscopic Major Resections. Thorac Surg Clin 2017; 27: 357-72. 21. Hu CG, Zheng K, Liu GH, Li ZL, Zhao YL, Lian JH, et al. Effectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer: a retrospective cohort study. Gen Thorac Cardiovasc Surg 2021; 69: 318-25. 6. 松浦奈都美, 井貝 仁, 矢澤友弘, 大沢 郁, 吉川良平, 上吉原光宏. 今月の臨床 原発性肺癌に対する単孔式胸腔鏡手術-多孔式胸腔鏡手術との比較・検討. 胸部外科 2021; 74: 167-71. 8. Alanwar M, Elsharawy M, Brik A, Ahmady I, Shemais DS. Safety and perioperative outcomes of uniportal versus multiportal video-assisted thoracoscopic surgery. J Minim Access Surg 2024; 20: 294-300. 20. Zhang K, Liu W, Zhao Y, Gao X, Dai W, Zhou X, et al. Comparison of early postoperative patient-reported outcomes after multiportal robotic-assisted thoracoscopic surgery and uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer. Eur J Surg Oncol 2024; 50: 108481. 4. Gonzalez-Rivas D, Manolache V, Bosinceanu ML, Gallego-Poveda J, Garcia-Perez A, de la Torre M, et al. Uniportal pure robotic-assisted thoracic surgery-technical aspects, tips and tricks. Ann Transl Med 2023; 11: 362. 5. Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant 2013; 48: 452-8. 10. Mizukami Y, Takahashi Y, Adachi H. Single-Port vs Conventional Three-Port Video-Assisted Thoracoscopic Pulmonary Wedge Resection: Comparison of Postoperative Pain and Surgical Costs. Ann Thorac Cardiovasc Surg 2021; 27: 91-6. 3. Gonzalez-Rivas D, Fieira E, Delgado M, de la Torre M, Mendez L, Fernandez R. Uniportal video-assisted thoracoscopic sleeve lobectomy and other complex resections. J Thorac Dis 2014; 6: S674-81. 9. 石黒太志, 梁 泰基, 竹中裕史, 川崎成章, 重光希公生. 当院でのUniportal VATS (単孔式胸腔鏡手術) 導入後の周術期成績. 日呼外会誌 2019; 33: 693-700. 16. Zhang C, Jiang D, Luo C, Yuan D, Shang G. Perioperative Effect of Single-Port Thoracoscopic Segmentectomy and Three-Port Thoracoscopic Segmentectomy in the Treatment of Early Non-Small-Cell Lung Cancer. Comput Math Methods Med 2023; 2023: 7550317. 19. Zheng X, Wang W, Li X, He P, Wu X. Efficacy of uniportal versus multiportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer: A retrospective analysis. Pak J Med Sci 2024; 40: 1135-9. |
| References_xml | – reference: 11. Sano Y, Okazaki M, Shigematsu H, Yamashita N, Sugimoto R, Sakao N, et al. Quality of life after partial lung resection with uniportal versus 3-port video-assisted thoracoscopic surgery: a prospective randomized controlled study. Surg Today 2021; 51: 1755-63. – reference: 13. Igai H, Kamiyoshihara M. Uniportal thoracoscopic fissureless right lower lobectomy using the suction device trick. Multimed Man Cardiothorac Surg. [Internet]. 2019 Dec. 20 [cited 2024 Dec. 19]; 2019: [about 1p.]. Available from: https://mmcts.org/tutorial/1370. – reference: 14. Gonzalez-Rivas D, Sihoe ADL. Important Technical Details During Uniportal Video-Assisted Thoracoscopic Major Resections. Thorac Surg Clin 2017; 27: 357-72. – reference: 2. Gonzalez D, Paradela M, Garcia J, Dela Torre M. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg 2011; 12: 514-5. – reference: 17. Nii K, Igai H, Numajiri K, Ohsawa F, Kamiyoshihara M. Uniportal thoracoscopic mediastinal lymphadenectomy using appropriate surgical steps. J Thorac Dis 2024; 16: 321-32. – reference: 8. Alanwar M, Elsharawy M, Brik A, Ahmady I, Shemais DS. Safety and perioperative outcomes of uniportal versus multiportal video-assisted thoracoscopic surgery. J Minim Access Surg 2024; 20: 294-300. – reference: 7. Xiang Z, Wu B, Zhang X, Wei Y, Xu J, Zhang W. Uniportal versus multiportal video-assisted thoracoscopic segmentectomy for non-small cell lung cancer: a systematic review and meta-analysis. Surg Today 2023; 53: 293-305. – reference: 20. Zhang K, Liu W, Zhao Y, Gao X, Dai W, Zhou X, et al. Comparison of early postoperative patient-reported outcomes after multiportal robotic-assisted thoracoscopic surgery and uniportal video-assisted thoracoscopic surgery for non-small cell lung cancer. Eur J Surg Oncol 2024; 50: 108481. – reference: 16. Zhang C, Jiang D, Luo C, Yuan D, Shang G. Perioperative Effect of Single-Port Thoracoscopic Segmentectomy and Three-Port Thoracoscopic Segmentectomy in the Treatment of Early Non-Small-Cell Lung Cancer. Comput Math Methods Med 2023; 2023: 7550317. – reference: 5. Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant 2013; 48: 452-8. – reference: 18. Lim E, Harris RA, Batchelor T, Casali G, Krishnadas R, Begum S, et al. Outcomes of single- versus multi-port video-assisted thoracoscopic surgery: Data from a multicenter randomized controlled trial of video-assisted thoracoscopic surgery versus thoracotomy for lung cancer. JTCVS Open 2024; 19: 296-308. – reference: 1. Rocco G, Martin-Ucar A, Passera E. Uniportal VATS Wedge Pulmonary Resections. Ann Thorac Surg 2004; 77: 726-8. – reference: 12. Wu CY, Chen YY, Chang CC, Yen YT, Lai WW, Huang WL, et al. Single-port thoracoscopic anatomic resection for chronic inflammatory lung disease. BMC Surg 2021; 21: 244. – reference: 10. Mizukami Y, Takahashi Y, Adachi H. Single-Port vs Conventional Three-Port Video-Assisted Thoracoscopic Pulmonary Wedge Resection: Comparison of Postoperative Pain and Surgical Costs. Ann Thorac Cardiovasc Surg 2021; 27: 91-6. – reference: 4. Gonzalez-Rivas D, Manolache V, Bosinceanu ML, Gallego-Poveda J, Garcia-Perez A, de la Torre M, et al. Uniportal pure robotic-assisted thoracic surgery-technical aspects, tips and tricks. Ann Transl Med 2023; 11: 362. – reference: 9. 石黒太志, 梁 泰基, 竹中裕史, 川崎成章, 重光希公生. 当院でのUniportal VATS (単孔式胸腔鏡手術) 導入後の周術期成績. 日呼外会誌 2019; 33: 693-700. – reference: 21. Hu CG, Zheng K, Liu GH, Li ZL, Zhao YL, Lian JH, et al. Effectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer: a retrospective cohort study. Gen Thorac Cardiovasc Surg 2021; 69: 318-25. – reference: 19. Zheng X, Wang W, Li X, He P, Wu X. Efficacy of uniportal versus multiportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer: A retrospective analysis. Pak J Med Sci 2024; 40: 1135-9. – reference: 6. 松浦奈都美, 井貝 仁, 矢澤友弘, 大沢 郁, 吉川良平, 上吉原光宏. 今月の臨床 原発性肺癌に対する単孔式胸腔鏡手術-多孔式胸腔鏡手術との比較・検討. 胸部外科 2021; 74: 167-71. – reference: 22. Matsuura N, Igai H, Ohsawa F, Yazawa T, Kamiyoshihara M. Uniport vs. multiport video-assisted thoracoscopic surgery for anatomical lung resection-which is less invasive? J Thorac Dis 2021; 13: 244-51. – reference: 15. Ruan Y, Cao W, Xue H, You M, Zhao Z. Long-term outcome of uniport vs. multiport video-assisted thoracoscopic lobectomy for lung cancer. Sci Rep 2024; 14: 5316. – reference: 3. Gonzalez-Rivas D, Fieira E, Delgado M, de la Torre M, Mendez L, Fernandez R. Uniportal video-assisted thoracoscopic sleeve lobectomy and other complex resections. J Thorac Dis 2014; 6: S674-81. |
| SSID | ssib002223836 ssib002809429 ssib006158315 ssib000936850 ssib005901879 ssj0061428 ssib050939265 ssib003115996 ssib023160720 ssib002484544 ssib058493845 ssib006554584 |
| Score | 2.3962812 |
| Snippet | ... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 390 |
| SubjectTerms | 低侵襲手術 単孔 単孔式胸腔鏡手術 周術期成績 胸腔鏡手術 |
| Title | 当院における単孔式胸腔鏡手術の周術期成績 |
| URI | https://www.jstage.jst.go.jp/article/jacsurg/39/5/39_390/_article/-char/ja |
| Volume | 39 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本呼吸器外科学会雑誌, 2025/07/15, Vol.39(5), pp.390-398 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1PaxQxFB_aevEiior_6cGcytbszGTmPfGSWWcpioJQobdlZzYr9KBS24u3VQS1SC3tQUGQehJEzz2o30WWre238OVldjctHqx6Gd4keS_vvUyY38tMXoLgciI7MjIdVTNpO7KfGbs1LOOk1iGIFGJRNwUfyXLrdjJ3N76xoBYmJn94fy2tLBez5ePf7iv5m1GlMhpXu0v2ECM7EkoFRNP40pVGmK5_NMYiVyK7LjASOQpEoUORR4QNhc4qAnRFYJ2JUEBmuYC4wBKaiJjlNAQ0RQ4CIpEBE4qr0JZrYk8EILODvbWdur5yy07yNXhVicCGwCZzgUAp8tSKzXIfDXOzVGhVtdeNSlTmCMmaKDbNaRsLTKwonbJFrL-mktiyoGY_ZFxFmmgBozVg7iERmWRbyTFqhiWTQxrMrsV4yYILgJ3HWpDd1mc5GcRc5BlXRLZDcx-XFqisguS5TM5wr2hdSoppeUCfLKwMJa2ybGbYq7R1ZG-G_pJMqOxar9uUypPovzvPX7W1e87QZeCcNe6dBVCnWeYy4A9fai5DVDV5lfeGitzprBXYidwR4Affo4RRFJ_fUD5aWbo3SzNvxLYvN3n15Leqhq0IW8peqHVrWGd3D1KDyeBImKb8J8XNO14EgPYEBH8rNmHIyIt4Y4iVj0CBrPcQvU0WhV7GSLuVGrwPzwTYIfIQb6Lsl-KRPIpuEpmOIyaCzxQwjD_8U1OMIB5F1IlNUMjpO6txcHlgrb-u7PcWIdpFiu-G_4YyXJ0_Hhyr4sxp7dxzIphYbJ8Mrg2-bey9_dDvfer3XvZ76_0nq4NXbwafNwdf13afbu8-29xb29p5sbq7tdHvfRmsfyRi5937neevf25_PxXMN_P5xlytOj6ltkhOadcKDIs4xo4qC1K0DW1I0JRx3Ri0UVyKXWNMGxNDeDUs26WEUnZVJwwRZJcCi9PB1P0H982ZYDrtRMbUC8JokU0vVUDZLZUkUQnBLAnds8FVZ2vroUuR0zrEg3HuX5jPB0fHE_BCMLW8tGIuUpSwXFzi5-wXJHDVCQ |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E5%BD%93%E9%99%A2%E3%81%AB%E3%81%8A%E3%81%91%E3%82%8B%E5%8D%98%E5%AD%94%E5%BC%8F%E8%83%B8%E8%85%94%E9%8F%A1%E6%89%8B%E8%A1%93%E3%81%AE%E5%91%A8%E8%A1%93%E6%9C%9F%E6%88%90%E7%B8%BE&rft.jtitle=%E6%97%A5%E6%9C%AC%E5%91%BC%E5%90%B8%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E6%96%B0%E5%B1%85+%E5%92%8C%E4%BA%BA&rft.au=%E4%B8%8A%E5%90%89%E5%8E%9F+%E5%85%89%E5%AE%8F&rft.au=%E4%BA%95%E7%94%B0+%E6%99%83%E9%A0%8C&rft.au=%E6%B2%BC%E5%B0%BB+%E4%B8%80%E6%A8%B9&rft.date=2025-07-15&rft.pub=%E6%97%A5%E6%9C%AC%E5%91%BC%E5%90%B8%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0919-0945&rft.eissn=1881-4158&rft.volume=39&rft.issue=5&rft.spage=390&rft.epage=398&rft_id=info:doi/10.2995%2Fjacsurg.39.390&rft.externalDocID=article_jacsurg_39_5_39_390_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0919-0945&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0919-0945&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0919-0945&client=summon |