TITLE:
Uniportal Video-Assisted Thoracic Surgery (U-VATS): Experiences and Challenges in Oncologic Patients in the Dominican Republic
AUTHORS:
Hernán Oliu Lambert, Natalia Altagracia de la Cruz de Oliu, Ana María Nazario Dolz, Orestes Noel Mederos Curbelo
KEYWORDS:
Uniportal VATS, Thoracic Oncology, Lobectomy, Dominican Republic, Minimally Invasive
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.14 No.3,
September
30,
2024
ABSTRACT: Introduction: Uniportal Video-Assisted Thoracic Surgery (U-VATS) has appeared as a promising, minimally invasive approach for thoracic oncology, offering benefits such as reduced trauma, shorter recovery times, and lower complication rates. However, its adoption in resource-limited settings faces challenges, primarily due to limited access to specialized equipment, training, and infrastructure. Methods: This retrospective study evaluated the outcomes of 138 oncologic patients who underwent U-VATS between 2020 and 2024 at two centers in the Dominican Republic. Patients included those with primary lung cancer, pulmonary metastases, or masses requiring diagnostic biopsy. Data was extracted from patient records including epidemiological variables and clinical variables, treatments, and complications. A descriptive analysis was performed to summarize the data. Frequencies and percentages were calculated to report demographic and clinical characteristics, types of procedures, and postoperative outcomes. Results: The study population was predominantly middle-aged, with a near-equal gender distribution. Most patients underwent lung biopsies (63%), followed by lobectomies (22.5%) and metastasectomies (14.5%). The overall complication rate was low, with only 2.1% experiencing wound infections or atelectasis. The majority (87%) were discharged within 24 hours. These findings underscore U-VATS as a safe and effective choice for thoracic oncology in this setting. Conclusions: U-VATS shows promising outcomes in oncologic patients in the Dominican Republic, proving its feasibility and safety in a resource-limited environment. However, widespread adoption requires investment in infrastructure, training, and insurance coverage. Phased implementation, public-private partnerships, and cost-benefit analyses could support broader accessibility and integration of U-VATS, potentially improving patient outcomes and reducing healthcare costs in similar settings.