Multiportal versus uniportal VATS for lung resections: A comparative study of outcomes and efficiency

Abstract

<bold>Background:</bold> Posterolateral thoracotomy has long been the standard for major pulmonary resections. Recently, multiportal (mVATS) and uniportalal VATS (uVATS) have shown comparable or superior outcomes. <bold>Objectives:</bold> To assess minimally invasive lung resections and compare mVATS and uVATS regarding indications, operative duration, complications, pain, and outcomes. <bold>Methods:</bold> This prospective and analytical study included major pulmonary resections performed via mVATS or uVATS in our department (2016–2024). <bold>Results:</bold> Among 38 cases (mVATS: 47.4%, uVATS: 52.6%), mean patient age was 57.6 years (23-79 years), with a male predominance (sex ratio: 1.71). Lung cancer was the main indication (73.7%), with a median tumor size of 36 mm. Median FEV1 was 70% and VC 79%. Lobectomy was most frequent (89.4%). The median operative duration was 160min (mVATS: 120 min, uVATS: 90 min; p=0.031). There was no difference between both groups in term of bleeding, and conversions. Complications occurred in 34% of cases, mostly Clavien-Dindo I–II, with no significant difference (p=0.85). Postoperative pain (VAS) was 7 at 24h and 2 at discharge for uVATS vs. 5 and 2 for mVATS (p=0.26). Mean analgesic use was 14 days (mVATS) vs. 10 days (uVATS) (p=0.07). <bold>Conclusion:</bold> mVATS and uVATS are effective and comparable for anatomical lung resections. uVATS had a shorter operative duration, with no significant differences in complications or outcomes.