Updates on Minimally Invasive Surgery in Non-Small Cell Lung Cancer
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Video-assisted thoracic surgery (VATS) has become widely used since the 1990s and has become a standard treatment approach mainly for early-stage non-small cell lung cancer. The few randomized controlled trials providing evidence of the effectiveness of VATS lobectomy at present are supported by a large number of propensity-matched studies, several high-quality meta-analyses, and outcome studies. These studies provide comprehensive data demonstrating the lower morbidity, shorter chest tube duration, and shorter hospital stay of VATS than thoracotomy during the postoperative course. Moreover, VATS shows equivalent oncological outcome as thoracotomy and therefore should be performed for lobectomy as much as possible. Importantly, VATS has recently been applied to advanced cases and previously contraindicated complex procedures such as bronchoplasty and chest wall resection. Attention has also been paid to reduced port surgery performed by frontier surgeons. Thus, the indications of VATS have seen a significant expansion. This major development logically negates any hesitation to change to the VATS technique as any doubt will likely constrain its wider applications. Preparation of scientific learning environments is necessary and should be actively pursued to adopt new skills instead of debating between the choice of “VATS or open.”
KeywordsLung cancer Minimally invasive surgery Video-assisted thoracic surgery (VATS)
We thank Dr. Edward Barroga (http://orcid.org/0000-0002-8920-2607), a professional medical editor and an Associate Professor of the Department of Medical Education of Tokyo Medical University, for reviewing and editing the manuscript.
Compliance with Ethical Standards
Conflict of Interest
Norihiko Ikeda has received research funding from AstraZeneca, Pfizer, Merck Sharpe & Dohme, Eli Lilly Japan, Chugai Pharmaceutical Co., Ltd., Taiho Pharmaceutical, Boehringer Ingelheim, and Ono Pharmaceutical Co., Ltd.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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