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Analysis of the safety and feasibility of subcutaneous areolar tunnel single-port thoracoscopic radical resection for lung cancer: a retrospective cohort study
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DOI：10.1007/s13304-025-02514-5.png)
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Abstract
En 中文
This study aims to evaluate the surgical efficacy and safety of subareolar subcutaneous tunnel single-port thoracoscopic radical resection in the treatment of lung cancer. Retrospective analysis of 61 lung cancer patients undergoing resection: 29 received areola subcutaneous tunneling single-port resection, and 32 conventional single-port VATS. Perioperative param-eters, complications, and 1-month outcomes were compared. There were no statistically significant differences between the two groups with respect to intraoperative operation time, total number of lymph nodes dissected, postoperative drain-age duration, total postoperative drainage volume, length of postoperative hospital stay, VAS pain score on postoperative day 3, or incidence of postoperative complications (all P > 0.05). However, The periareolar incision group demonstrated significantly lower intraoperative blood loss (63.62 +/- 11.49 mL vs. 77.03 +/- 14.19 mL), lower VAS pain scores on the first postoperative day (3.69 +/- 1.49 vs. 4.88 +/- 1.72) and second postoperative day (3.31 +/- 1.39 vs. 4.28 +/- 1.76), and a lower rate of postoperative analgesic prescriptions (20.69% vs. 53.13%) compared to the single-port group (all P < 0.05). However, the periareolar approach was associated with longer surgical approach time (3.40 +/- 0.28 min vs. 1.68 +/- 0.27 min), pro-longed total operation duration (124.12 +/- 8.25 min vs. 118.21 +/- 9.28 min), and an increased incidence of subcutaneous fluid accumulation in the tunnel area (13.79% vs. 0%) (all P < 0.05). One areola-group conversion to open surgery occurred. No perioperative deaths or breast injuries were observed. Scarring and sensory disturbances were significantly reduced in the areola group. Areola subcutaneous tunneling single-port resection is safe and feasible, with perioperative outcomes comparable to conventional VATS. It reduces early postoperative pain and improves cosmesis but requires vigilance for tunnel-related fluid accumulation. This approach offers a viable option for patients prioritizing aesthetic outcomes. This study, being a retrospective analysis, is subject to certain limitations, including a limited sample size and a relatively short follow-up duration. Therefore, the conclusions drawn require further validation through large-scale, prospective studies with robust designs.
Keywords:
Video-assisted thoracoscopy
Lung cancer
Single-port thoracoscopy
Areola incision
Subcutaneous tunnel
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