To explore the short-term efficacy and learning curve of single-direction uniport video-assisted thoracoscopic surgery (SU-VATS) lobectomy for lung cancer.

Clinical data of consecutive VATS lobectomy with systematic lymph nodes dissection using single-direction approach by the same surgeon between Jan. 2016 and Feb. 2018 was retrospectively analyzed. The surgeon had mastered the single-direction multiple-port VATS (SM-VATS) lobectomy and conventional U-VATS lobectomy. These patients were divided into SU-VATS (91 cases)and SM-VATS (50 cases) while the SU-VATS group was further divided into three subgroups including SU-A (30 cases), SU-B (30 cases) and SU-C (31 cases). The operation time, blood loss during the surgery, number and stations of dissected lymph nodes, postoperative chest drainage, complications, visual analogue pain scale and hospital stay were compared respectively between the groups.

There was no short-term mortality, followed by tumor-negative surgical margin. One patient in SU-A group was converted to three-port VATS because of injury of abnormal vascular branch. Besides, the cases in SU-VATS group showed a tendency of gradually decreased operation time and blood loss, as compared with SM-VATS group. The operation time of SU-A group was significantly longer than the SU-B, SU-C and SM-VATS groups [(128.8 ± 30.0) min vs (101.7 ± 19.3) min vs (100.3 ± 23.3) min vs (103.2 ± 25.2) min, P<0.001], meanwhile, the blood loss of SU-A group was noticeably more than that in the SU-B, SU-C and SM-VATS groups [(185.0 ± 78.9) ml vs (148.3 ± 60.9) ml vs (150.0 ± 54.8) ml vs (146.0 ± 71.3) ml, P<0.05].

SU-VATS lobectomy for lung cancer is reliable, and the learning curve is nearly 30 cases for experienced surgeon who have mastered the single-direction and uniportal approaches. The short-term efficacy of SU-VATS is non-inferior to SM-VATS.

Single-direction; Single-port; Video-assisted thoracic surgery; Lobectomy