Complete versus assisted thoracoscopic approach: a prospective randomized trial comparing a variety of video-assisted thoracoscopic lobectomy techniques

  • N. Shigemura
  • A. Akashi
  • T. Nakagiri
  • M. Ohta
  • H. Matsuda
Original article

Abstract

Background

Video-assisted thoracoscopic surgery (VATS) lobectomy does not represent a unified approach, but rather a spectrum of operative techniques ranging from a complete endoscopic thoracotomy to a minithoracotomy. A prospective randomized trial was conducted to compare the differences in these techniques and their results to determine the best of VATS lobectomy for lung cancer.

Methods

This study randomized 39 consecutive patients with clinical stage I lung cancer to undergo either a complete (C-VATS, n = 20) or an assisted (A-VATS, n = 19) VATS approach for pulmonary lobectomy.

Results

The operating time was longer (p = 0.002) and blood loss was less (p = 0.004) with C-VATS than with A-VATS. Although there was no significant difference in analgesic use or duration of thoracic drainage between the groups, a shorter hospitalization was observed after C-VATS. Serum peak levels of postoperative inflammatory markers (white blood cell count, C-reactive protein, creatine phosphokinase) were lower with C-VATS and an earlier return to normalization than with A-VATS.

Conclusion

Various differences exist among the VATS lobectomy techniques, and complete VATS lobectomy as a purely endoscopic surgery may be technically feasible and a satisfactory alternative to the conventional procedure for stage I lung cancer.

Keywords

VATS lobectomy Lung cancer Thoracoscopy Prospective randomized trial Stapler 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • N. Shigemura
    • 1
  • A. Akashi
    • 1
  • T. Nakagiri
    • 1
  • M. Ohta
    • 2
  • H. Matsuda
    • 2
  1. 1.Division of the General Thoracic SurgeryTakarazuka Municipal HospitalHyogoJapan
  2. 2.Department of SurgeryOsaka University Graduate School of MedicineSuitaJapan

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