Perioperative and oncological outcomes of single-port versus two-port thoracoscopic lobectomy for non-small cell lung cancer: a propensity score-matched retrospective study.

Authors

Weiqing Li, Xiaoxiao Yang, Xuefeng Hao, Lihui Ke, Bo Wei

Published in

American journal of cancer research. Volume 16. Issue 9. Pages 4089-4101. Epub Sep 15, 2026.

Abstract

Although single-port video-assisted thoracoscopic surgery (VATS) lobectomy is increasingly adopted for non-small cell lung cancer (NSCLC), evidence comparing its long-term oncological efficacy with that of the two-port approach remains scarce. This propensity score-matched study evaluated perioperative outcomes, postoperative recovery, and 3-year survival following single-port versus two-port thoracoscopic lobectomy in patients with NSCLC. We retrospectively analyzed 167 consecutive patients (single-port, n = 82; two-port, n = 85); propensity score matching (1:1, caliper = 0.2) yielded 72 matched pairs. Perioperative outcomes, postoperative pain (VAS), inflammatory markers (CRP, PCT, IL-1β), pulmonary function, 30-day complications, 3-year overall survival (OS), disease-free survival (DFS), and multivariable Cox regression were compared. Following matching, the single-port group demonstrated significantly longer operative time (187.3 ± 56.4 vs. 142.2 ± 49.4 minutes; P<0.001) but reduced blood loss (96.5 ± 42.0 vs. 121.7 ± 48.1 mL; P<0.001) 24-hour chest drainage volume (632.3 ± 447.3 vs. 945.5 ± 501.3 mL; P<0.001), and incision length (3.57 ± 1.37 vs. 4.94 ± 1.52 cm; P<0.001). Lymph node yield did not differ significantly (17.3 ± 4.1 vs. 16.1 ± 3.6; P = 0.058). Postoperative VAS scores were significantly lower in the single-port group on days 3, 5, and 7 (all P<0.001), with attenuated inflammatory responses (lower CRP, PCT, and IL-1β; all P<0.001) and better pulmonary function recovery (higher PaO₂, SpO₂, FVC, and FEV₁; all P<0.05). Thirty-day complication rates did not differ significantly (6.9% vs. 9.7%; P = 0.763). Over a median follow-up of 38 months, 3-year OS (86.5% vs. 84.4%; P = 0.572) and 3-year DFS (79.2% vs. 77.1%; P = 0.684) were comparable. Multivariable analysis identified pathological stage II (HR, 2.45; 95% CI, 1.35-4.43; P = 0.003) and lymphovascular invasion (HR, 2.10; 95% CI, 1.18-3.72; P = 0.012) as independent predictors of poorer DFS, whereas surgical approach was not associated with DFS or OS. In conclusion, single-port thoracoscopic lobectomy was associated with reduced surgical trauma, decreased postoperative pain and inflammation, and improved pulmonary function recovery, without compromising lymph node dissection, short-term safety, or 3-year oncological outcomes. These findings support the continued use and wider adoption of single-port VATS in appropriately selected patients with NSCLC, while acknowledging that Stage I disease predominance limits generalizability to more advanced stages.

PMID:
42908704
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.