Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS)
Por:
Bertolaccini, L, Batirel, H, Brunelli, A, Gonzalez-Rivas, D, Ismail, M, Ucar, A, Ng, C, Scarci, M, Sihoe, A, Ugalde, P, Abu Akar, F, Bedetti, B, Nadal, S, Brandolini, J, Crucitti, P, Enyedi, A, Fernando, H, Furak, J, Gallego-Poveda, J, Galvez-Munos, C, Hanke, I, Hernandez-Arenas, L, Janik, M, Juhos, P, Libretti, L, Lucciarini, P, Macri, P, Margaritora, S, Mahoozi, H, Nachira, D, Pardolesi, A, Pischik, V, Sagan, D, Schreurs, H, Sekhniaidze, D, Socci, L, Tosi, D, Turna, A, Vannucci, F, Zielinski, M, Rocco, G, UVIG and ESTS
Publicada:
1 ago 2019
Resumen:
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.
Filiaciones:
Bertolaccini, L:
Maggiore Teaching Hosp, Dept Thorac Surg, Bologna, Italy
Batirel, H:
Marmara Univ Hosp, Dept Thorac Surg, Istanbul, Turkey
Brunelli, A:
St James Univ Hosp, Dept Thorac Surg, Leeds, W Yorkshire, England
Gonzalez-Rivas, D:
Coruna Univ Hosp, Dept Thorac Surg, Minimally Invas Thorac Surg Unit UCTMI, Coruna, Spain
Ismail, M:
Klinikum Ernst von Bergmann, Dept Thorac Surg, Potsdam, Germany
Ucar, A:
Sheffield Teaching Hosp, Thorac Surg Units, Sheffield, S Yorkshire, England
Ng, C:
Chinese Univ Hong Kong, Dept Surg, Hong Kong, Peoples R China
Scarci, M:
San Gerardo Hosp, Dept Thorac Surg, Monza, Italy
Sihoe, A:
Univ Hong Kong, Li Ka Shing Fac Med, Dept Surg, Hong Kong, Peoples R China
Tongji Univ, Dept Thorac Surg, Shanghai Pulm Hosp, Shanghai, Peoples R China
Ugalde, P:
Hop Laval, Dept Thorac Surg, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada
Abu Akar, F:
Makassed Charitable Soc Hosp, Dept Cardiothorac Surg, East Jerusalem, Israel
Shaare Zedek Med Ctr SZMC, Dept Cardiothorac Surg, Jerusalem, Israel
Bedetti, B:
Malteser Hosp, Dept Thorac Surg, Bonn, Germany
:
Gen Univ Hosp, Dept Thorac Surg, Alicante, Spain
Brandolini, J:
Maggiore Teaching Hosp, Dept Thorac Surg, Bologna, Italy
Crucitti, P:
Campus Biomed Univ Rome, Div Thorac Surg, Rome, Italy
Enyedi, A:
Univ Debrecen, Div Thorac Surg, Debrecen, Hungary
Fernando, H:
Dept Surg, Fairfax Med Campus, Fairfax, VA USA
Furak, J:
Univ Szeged, Dept Surg, Szeged, Hungary
Gallego-Poveda, J:
Santa Maria Univ Hosp, Dept Cardiothorac, Lisbon, Portugal
Galvez-Munos, C:
Gen Univ Hosp, Dept Thorac Surg, Alicante, Spain
Hanke, I:
Univ Hosp Hradec Kralove, Dept Thorac Surg, Hradec Kralove, Czech Republic
Hernandez-Arenas, L:
Univ Hosp Birmingham NHS Fdn Trust, Dept Thorac Surg, Birmingham, W Midlands, England
Janik, M:
Slovak Med Univ, Univ Hosp Bratislava, Dept Thorac Surg, Bratislava, Slovakia
Juhos, P:
Slovak Med Univ, Univ Hosp Bratislava, Dept Thorac Surg, Bratislava, Slovakia
Libretti, L:
San Gerardo Hosp, Dept Thorac Surg, Monza, Italy
Lucciarini, P:
Med Univ Innsbruck, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria
Macri, P:
Ist Clin Humanitas CCO Catania, Thorac Surg Unit, Catania, Italy
Margaritora, S:
Fdn Policlin Univ A Gemelli, Dept Gen Thorac Surg, Rome, Italy
Mahoozi, H:
Evangel Krankenhaus Herne, Dept Thorac Surg, Herne, Germany
Nachira, D:
Fdn Policlin Univ A Gemelli, Dept Gen Thorac Surg, Rome, Italy
Pardolesi, A:
Natl Canc Inst, Dept Thorac Surg, Milan, Italy
Pischik, V:
St Petersburg State Univ, Fac Med, St Petersburg, Russia
Sagan, D:
Med Univ Lublin, Dept Thorac Surg, Lublin, Poland
Schreurs, H:
Med Ctr Alkmaar, Alkmaar, Netherlands
Sekhniaidze, D:
Reg Clin Hosp, Dept Thorac Surg, Tyumen, Russia
Socci, L:
Sheffield Teaching Hosp, Thorac Surg Units, Sheffield, S Yorkshire, England
Tosi, D:
Istanbul Univ Cerrahpasa, Dept Thorac Surg, Cerrahpasa Med Sch, Istanbul, Turkey
Turna, A:
Fdn Ca Granda Osped Maggiore Policlin, Div Thorac & Transplant Surg, Milan, Italy
Vannucci, F:
Hosp Fed Andarai, Dept Thorac Surg, Rio De Janeiro, Brazil
Zielinski, M:
Pulm Hosp, Dept Thorac Surg, Zakopane, Poland
Rocco, G:
Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Serv, 1275 York Ave, New York, NY 10021 USA
Bronze
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