Survival Effectiveness of Uniport Anatomic Resections in Patients With Clinical Stage I Lung Cancer: An Observation Cohort Study

ABSTRACT Objective Although uniportal video‐assisted thoracoscopic surgery (uVATS) is increasingly adopted for early‐stage lung cancer, long‐term survival data comparing different forms of anatomic resection remain limited. This study aimed to evaluate the long‐term oncologic outcomes—specifically, 5‐year disease‐free survival (DFS) and overall survival (OS)—of patients with clinical stage I non‐small cell lung cancer (NSCLC) who underwent uVATS segmentectomy or lobectomy. Secondary outcomes included perioperative parameters and complication rates. Method We conducted a retrospective analysis of patients with clinical stage I NSCLC who underwent uVATS anatomical resection (lobectomy or segmentectomy) between January 2014 and December 2020. The primary endpoints were 5‐year DFS and OS, while the secondary endpoints included operative time, drainage duration, hospital stay, conversion rates, and postoperative complications. Results A total of 386 patients with clinical stage I NSCLC underwent uVATS anatomical resection, with 280 receiving lobectomy and 106 undergoing segmentectomy. The 5‐year DFS and OS rates did not significantly differ between segmentectomy and lobectomy for patients with pathological stage IA tumors. Segmentectomy was associated with a shorter drainage duration. The overall conversion rate to multiple‐port VATS or thoracotomy was 1.8%, with no 30‐day surgical mortality observed. Prolonged air leaks were the most common complication. Conclusion uVATS anatomical resection is an effective treatment option for clinical stage I NSCLC, offering comparable long‐term survival outcomes for segmentectomy and lobectomy in selected patients. Further prospective studies are warranted to confirm these findings and optimize patient selection.