Skip to main content

Lobectomy: Video-Assisted thoracic surgery versus posterolateral thoracotomy

The Japanese Journal of Thoracic and Cardiovascular Surgery volume 46, pages 519–522 (1998)Cite this article

Abstract

Background:Video-assisted lobectomy has been adopted by many thoracic surgeons, because it is a less invasive approach to small peripheral lung cancers. However, some authors disagree that video-assisted lobectomy is less invasive than traditional thoracotomy and lobectomy. The purpose of this study was to evaluate the advantages of video-assisted lobectomy over posterolateral thoracotomy and lobectomy in terms of pain-related morbidity. Methods: A total of 70 patients with clinical T1N0M0 non-small-cell lung carcinomas underwent lobectomy with complete mediastinal lymphadenectomy. Of these 35 underwent posterolateral thoracotomy (between April 1994 and December 1995; open group), and 35 underwent video-assisted thoracic surgery (VATS) (between January and December 1996; VATS group). Results: Although the operative time was significantly longer in the VATS group (p=0.04), the intraoperative blood loss was significantly less (p=0.03). No significant differences were found for the two groups with respect to the total number of mediastinal lymph nodes dissected or duration of chest tube drainage. Postoperative pain was less severe as determined by the number of doses of analgesics required between postoperative days 0 and 7 (p<0.0001), and the length of postoperative hospitalization was shorter in the VATS group (p<0.0001). Conclusion: Video-assisted lobectomy is associated with decreased postoperative pain and shortened length of postoperative hospitalization, when compared with posterolateral thoracotomy and lobectomy.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Landreneau RJ, Hazelrigg SR, Mack MJ, Dowling RD, Burke D, Gavlick J, et al. Postoperative pain-related morbidity: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg 1993; 56: 1285–9.

    CAS  Google Scholar 

  2. Giudicelli R, Thomas P, Lonjon T, Ragni J, Morati N, Ottomani R, et al. Video-assisted minithoracotomy versus muscle-sparing thoracotomy for performing lobectomy. Ann Thorac Surg 1994; 58: 721–8.

    Google Scholar 

  3. Tschernko EM, Hofer S, Bieglmayer C, Wisser W, Haider W. Video-assisted wedge resection/lobectomy vs conventional axillary thoracotomy. Chest 1996; 109: 1636–42.

    CAS  Google Scholar 

  4. Liu HP, Chang CH, Lin PJ, Chang JP, Hsieh ML Thoracoscopic-assisted lobectomy, preliminary experience and results. Chest 1995; 107: 853–5.

    CAS  Google Scholar 

  5. Walker WS, Carnochan FM, Pugh GC. Thoracoscopic pulmonary lobectomy, early operative experience and preliminary clinical results. J Thorac Cardiovasc Surg 1993; 106: 1111–7.

    CAS  Google Scholar 

  6. McKenna RJ. Lobectomy by video-assisted thoracic surgery with mediastinal node sampling for lung cancer. J Thorac Cardiovasc Surg 1994; 107: 879–82.

    Google Scholar 

  7. Kirby TJ, Mack MJ, Landreneau RJ, Rice TW. Initial experience with video-assisted thoracoscopic lobectomy. Ann Thorac Surg 1993; 56: 1248–52.

    CAS  Google Scholar 

  8. Kirby TJ, Rice TW. Thoracoscopic lobectomy. Ann Thorac Surg 1993; 56: 784–6.

    CAS  Google Scholar 

  9. Walker WS, Carnochan FM, Tin M. Thoracoscopy assisted pulmonary lobectomy. Thorax 1993; 48: 921–4.

    CAS  Google Scholar 

  10. Roviaro G, Varoli F, Rebuffat C, Vergani C, D’Hoore A, Scalambra SM, et al. Major pulmonary resections: pneumonectomies and lobectomies. Ann Thorac Surg 1993; 56: 779–83.

    CAS  Google Scholar 

  11. Kirby TJ, Mack MJ, Landreneau RJ, Rice TW. Lobectomy — video-assisted thoracic surgery versus muscle-sparing thoracotomy. J Thorac Cardiovasc Surg 1995; 109: 997–1002.

    Article  CAS  Google Scholar 

  12. Asamura H, Nakayama H, Kondo H, Tsuchiya R, Shimosato Y, Naruke T. Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small-cell lung carcinomas: are these carcinoma candidates for video-assisted lobectomy? J Thorac Cardiovasc Surg 1996; 111: 1125–34.

    Article  CAS  Google Scholar 

  13. Landreneau RJ, Pigula F, Luketich JD, Keenan RJ, Bartley S, Fetterman LS, et al. Acute and chronic morbidity differences between muscle-sparing and standard lateral thoracotomies. J Thorac Cardiovasc Surg 1996; 112: 1346–51.

    Article  CAS  Google Scholar 

Download references

Author information

Affiliations

  1. Center of VATS, Minami-Ichijo Hospital, South-1, West-13, Chuo-ku, Sapporo, 060-0061, Japan

    Toshiro Ohbuchi MD & Eriho Takeuchi MD, PhD

  2. Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan

    Toshiaki Morikawa MD & Hiroyuki Kato MD, PhD

Authors
  1. Toshiro Ohbuchi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiaki Morikawa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eriho Takeuchi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Kato MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ohbuchi, T., Morikawa, T., Takeuchi, E. et al. Lobectomy: Video-Assisted thoracic surgery versus posterolateral thoracotomy. Jpn J Thorac Caridovasc Surg 46, 519–522 (1998). https://doi.org/10.1007/BF03250590

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03250590

Index words

  • VATS
  • lobectomy
  • posterolateral thoracotomy