Abstract 214P
Background
To evaluate the impact of Uniportal Video-Assisted Thoracic Surgery (UVATS) with Three-Dimensional (3D) Vascular Mapping on reducing intraoperative complications, minimizing major bleeding, and accelerating postoperative recovery in central lung cancer patients treated with neoadjuvant chemoimmunotherapy (NACIT).
Methods
This single-center retrospective study included 200 central lung cancer patients who underwent NACIT between January 2019 and May 2024. Of these patients, 110 received preoperative 3D vascular mapping (UVATS+3D) and 90 underwent standard UVATS. Inverse Probability of Treatment Weighting and propensity score matching minimized bias. Multivariable linear regression and Cox proportional hazards models assessed complications and recovery outcomes, while Kaplan-Meier analysis evaluated 30-day complication-free survival. Subgroup analyses explored the impact of tumor location.
Results
After IPTW and PSM adjustment, the UVATS+3D group showed a significant reduction in intraoperative complications (8.2% vs. 18.9%, p=0.004) and major bleeding (>500 mL) (HR=0.48, 95% CI: 0.28–0.81, p=0.003). Subgroup analysis indicated that left upper lobe tumors benefited the most from 3D mapping, with a 72% reduction in major bleeding (p=0.014), followed by right upper lobe (65%, p=0.018), right middle lobe (58%, p=0.022), and both lower lobes (48%, p=0.028). The UVATS+3D group also had shorter hospital stays (4.8 ± 0.9 vs. 6.7 ± 1.5 days; p < 0.001) and faster lung function recovery (85.5% vs. 70% by day 7, p=0.015). Kaplan-Meier analysis showed higher 30-day complication-free survival (92.7% vs. 77.8%, p=0.003).
Conclusions
UVATS with 3D vascular mapping significantly reduces intraoperative complications, particularly in left upper lobe resections, and accelerates recovery in central lung cancer post-NACIT. These findings support broader adoption of 3D vascular mapping in UVATS, particularly in complex thoracic surgeries requiring precise vascular visualization.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.