Video-assisted thoracic surgery lobectomy reduces the morbidity after surgery for stage I non-small cell lung cancer

  • Masashi Muraoka
  • Tadayuki Oka
  • Shinji Akamine
  • Tsutomu Tagawa
  • Akihiro Nakamura
  • Satoshi Hashizume
  • Keitaro Matsumoto
  • Masato Araki
  • Yutaka Tagawa
  • Takeshi Nagayasu
Original Article

Abstract

Objective: We conducted this study to evaluate the surgical invasiveness and the safety of video-assisted thoracic surgery lobectomy for stage I lung cancer. Methods: Video-assisted thoracic surgery lobectomies were performed on 43 patients with clinical stage IA non-small cell lung cancer. We compared the surgical invasiveness parameters with 42 patients who underwent lobectomy by conventional thoracotomy. Results: Intraoperative blood loss was significantly less than that in the conventional thoracotomy group (151±149 vs. 362±321 g, p<0.01). Chest tube duration (3.0±2.1 vs. 3.9±1.9 days) was significantly shorter than those in the conventional thoracotomy group (p<0.05). The visual analog scale which was evaluated as postoperative pain level on postoperative day 7, maximum white blood count and C-reactive protein level were significantly lower than those in the conventional thoracotomy group (p<0.05). The morbidity rate was significantly lower than that in the conventional thoracotomy group (25.6% vs. 47.6%, p<0.05). Sputum retention and arrhythmia were significantly less frequent than in the conventional thoracotomy group (p<0.05). We experienced no operative deaths in both groups. Conclusion: We conclude that video-assisted thoracic surgery lobectomy for stage I non-small cell lung cancer patients is a less invasive and safer procedure with a lower morbidity rate compared with lobectomy by thoracotomy.

Key words

video-assisted thoracic surgery lung cancer operative morbidity 

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References

  1. 1.
    Kirby TJ, Rice TW. Thoracoscopic lobectomy. Ann Thorac Surg 1993; 56: 784–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Gharagozloo F, Tempesta B, Margolis M, Alexander EP. Video-assisted thoracic surgery lobectomy for stage I lung cancer. Ann Thorac Surg 2003; 76: 1009–15.PubMedCrossRefGoogle Scholar
  3. 3.
    McKenna RJ Jr. Thoracoscopic lobectomy with mediastinal sampling in 80-year-old patients. Chest 1994; 106: 1902–4.PubMedCrossRefGoogle Scholar
  4. 4.
    Koizumi K, Haraguchi S, Hirata T, Hirai, K, Mikami I, Fukushima M, et al. Video-assisted lobectomy in elderly lung cancer patients. Jpn J Thorac Cardiovasc Surg 2002; 50: 15–22.PubMedCrossRefGoogle Scholar
  5. 5.
    Nomori H, Horio H, Naruke T, Suemasu K. What is the advantage of a thoracoscopic lobectomy over a limited thoracotomy procedure for lung cancer surgery? Ann Thorac Surg 2001; 72: 879–84.PubMedCrossRefGoogle Scholar
  6. 6.
    Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: A comparison of VATS and conventional procedure. Ann Thorac Surg 2001; 72: 362–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Yim AP, Wan S, Lee TW, Arifi AA. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 2000; 70: 243–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy reduces cytokine production more than conventional open lobectomy. Jpn J Thorac Cardiovasc Surg 2000; 48: 161–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Nakagoe T, Sawai T, Tsuji T, Nanashima A, Jibiki M, Yamaguchi H, et al. Minilaparotomy wound edge protector (Lap-Protector): A new device. Surg Today 2001; 31: 850–2.PubMedCrossRefGoogle Scholar
  10. 10.
    Hazelrigg SR, Landreneau RJ, Boley TM, Priesmeyer M, Schmaltz RA, Nawarawong W, et al. The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain. J Thorac Cardiovasc Surg 1991; 101: 394–401.PubMedGoogle Scholar
  11. 11.
    Kaseda S, Aoki T, Hangai N, Shimizu K. Better pulmonary function and prognosis with video-assisted thoracic surgery than with thoracotomy. Ann Thorac Surg 2000; 70: 1644–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Birim O, Zuydendorp HM, Maat AP, Kappetein AP, Eijkemans MJ, Bogers AJ. Lung resection for non-small-cell lung cancer in patients older than 70: Mortality, morbidity, and late survival compared with the general population. Ann Thoracic Surg 2003; 76: 1796–801.CrossRefGoogle Scholar
  13. 13.
    Novoa N, Varela G, Jimenez MF., Morbidity after surgery for non-small cell lung carcinoma is not related to neoadjuvant chemotherapy. Eur J Cardiothorac Surg 2001; 20: 700–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Nakajima J, Takamoto S, Kohno T, Ohtsuka T. Cost of videothoracoscopic surgery versus open resection for patients with of lung carcinoma. Cancer 2000; 89: 2497–501.PubMedCrossRefGoogle Scholar
  15. 15.
    Stahl WM. Acute phase protein response to tissue injury. Crit Care Med 1987; 15: 545–50.PubMedCrossRefGoogle Scholar
  16. 16.
    el Hassan BS, Peak JD, Whicher JT, Shepherd JP. Acute phase protein levels as an index of severity of physical injury. Int J Oral Maxillofac Surg 1990; 19: 346–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Uzunkoy A, Coskun A, Akinci OF, Kocyigit A. Systematic stress response after laparoscopic or open hemia repair. Eur J Surg 2000; 166: 467–71.PubMedCrossRefGoogle Scholar
  18. 18.
    Hildebrandt U, Kessler K, Plusczyk T, Pistorius G, Vollmar B, Menger MD. Comparison of surgical stress between laparoscopic and open colonic resections. Surg Endosc 2003; 17: 242–6PubMedCrossRefGoogle Scholar
  19. 19.
    Meltzer HY. Plasma creatine phosphokinase activity, hyperthermia, and stress. Am J Physiol 1971; 221: 896–901.PubMedGoogle Scholar
  20. 20.
    Holub Z, Jabor A, Fischlova D, Palasek V, Shomani A. Evaluation of perioperative stress after laparoscopic and abdominal hysterectomy in premalignant and malignant disease of the uterine cervix and corpus. Clin Exp Obstet Gynecol 1999; 26: 12–5.PubMedGoogle Scholar
  21. 21.
    Mikami I, Koizumi K, Tanaka S. Changes in right ventricular performance in elderly patients who underwent lobectomy using video-assisted thoracic surgery for primary lung cancer. Jpn J Thorac Cardiovasc Surg 2001; 49: 153–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Tanita T, Hoshikawa Y, Tabata T, Noda M, Handa M, Kubo H, et al.: Functional evaluations for pulmonary resection for lung cancer in octogenarians. Investigation from postoperative complications. Jpn J Thorac Cardiovasc Surg 1999; 47: 253–61.PubMedGoogle Scholar
  23. 23.
    Cardinale D, Martinoni A, Cipolla CM, Civelli M, Lamantia G, Fiorentini C, et al. Atrial fibrillation, after operation for lung cancer: Clinical and prognostic significance. Ann Thorac Surg 1999; 68: 1827–31.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Association for Thoracic Surgery 2006

Authors and Affiliations

  • Masashi Muraoka
    • 1
  • Tadayuki Oka
    • 1
  • Shinji Akamine
    • 1
  • Tsutomu Tagawa
    • 1
  • Akihiro Nakamura
    • 1
  • Satoshi Hashizume
    • 1
  • Keitaro Matsumoto
    • 1
  • Masato Araki
    • 1
  • Yutaka Tagawa
    • 1
  • Takeshi Nagayasu
    • 1
  1. 1.Division of Surgical Oncology, Department of Translational Medical SciencesNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  2. 2.Department of Chest SurgeryOita Prefectural HospitalOitaJapan

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