To describe the technique and outcomes for an initial series of 200 cases of lobectomy and segmentectomy using single-intercostal two-port video-assisted thoracoscopic surgery(VATS), and investigate the effect of this technique on postoperative chronic pain.

Between June 2014 and August 2015, 217 consecutive patients attempted lobectomy and segmentectomy using single-intercostal two-port VATS. Between January 2014 and June 2014, the same surgeon continuously completed 80 cases of lobectomy and segmentectomy using three-port approach. The clinical data of all these patients were retrospectively analyzed, including the data on chronic pain at the follow-up 6 months after operation.

Among the 217 patients attempting lobectomy and segmentectomy using single-intercostal two-port VATS, 200 patients(173 cases of primary lung cancer and 27 cases of benign diseases) successfully completed the operation(141 cases of lobectomy and 59 cases of segmentectomy), and the other 17 patients transferred to three-port approach or open surgery due to various reasons. Of these 200 patients, the mean duration of surgery was (160.1 ± 56.1) min, the mean number of lymph node dissection was 10.5 ± 5.3, the mean duration of hospitalization after operation was (6.4 ± 2.9)d, complications occurred in 46 patients, and 1 patient died within 30 d after surgery. A total of 92 patients undergoing single-intercostal two-port VATS and 71 patients with three-port approach were successfully followed up 6 months after surgery, the prevalence of chronic pain and the mean chronic pain score of the former were significantly lower than that of the latter[25.0% vs 43.7%, χ²=6.300, P=0.012; (2.3±0.8) vs (3.6±1.6), t=3.912, P<0.001].

Lobectomy and segmentectomy using single-intercostal two-port VATS is safe and feasible for most patients. Compared with three-port approach, this technique significantly reduces the prevalence and score of chronic pain.