Skip to main content

Advertisement

SpringerLink
Log in

Complex video-assisted thoracoscopic surgery lobectomy for locally advanced lung cancer: a prospective feasibility study

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The limitations regarding indications for video-assisted thoracoscopic surgery lobectomy requiring complex surgery remain unclear. A prospective cohort study was conducted to elucidate the safety and feasibility of complex thoracoscopic lobectomy for patients with locally advanced non-small-cell lung cancer.

Methods

We planned to enroll patients who were suspected of needing thoracoscopic lobectomy or more with complex surgery, including tracheo-bronchoplasty, pulmonary arterioplasty, and combined resection of adjacent organs. Between February 2016 and January 2019, 28 consecutive patients were prospectively enrolled.

Results

After excluding 1 patient due to disease progression, 27 patients were included in this study. Three patients underwent thoracoscopic lobectomy without complex surgery. Of the remaining 24 patients, complex thoracoscopic lobectomy was successfully completed in 21 (88%), and the 3 conversions were due to surgery for the great vessels. All 27 patients achieved complete resection. Six patients (22%) suffered grade 2 complications, and the in-hospital, 30-day, and 90-day mortality rates were all 0%. At a median follow-up time of 900 days, the 3-year overall and disease-free survival rates were 75% and 54%, respectively.

Conclusions

Complex thoracoscopic lobectomy was shown to be safe and feasible in select patients with locally advanced non-small-cell lung cancer excluding invasion to the great vessels.

Clinical registration number

University Hospital Medical Information Network Clinical Trials Registry, 000,019,441 (JAPAN). Institutional Review Board number: 46-15-0003 (accepted at September 7, 2015).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Petersen RP, Pham D, Toloza EM, Burfeind WR, Harpole DH Jr, Hanish SI, et al. Thoracoscopic lobectomy: a safe and effective strategy for patients receiving induction therapy for non-small cell lung cancer. Ann Thorac Surg. 2006;82:214–9.

    Article  Google Scholar 

  2. Hennon M, Sahai RK, Yendamuri S, Tan W, Demmy TL, Nwogu C. Safety of thoracoscopic lobectomy in locally advanced lung cancer. Ann Surg Oncol. 2011;18:3732–6.

    Article  Google Scholar 

  3. Huang J, Xu X, Chen H, Yin W, Shao W, Xiong X, et al. Feasibility of complete video-assisted thoracoscopic surgery following neoadjuvant therapy for locally advanced non-small cell lung cancer. J Thorac Dis. 2013;5:S267–73.

    PubMed  PubMed Central  Google Scholar 

  4. Nakanishi R, Fujino Y, Yamashita T, Shinohara S, Oyama T. Thoracoscopic anatomic pulmonary resection for locally advanced non-small cell lung cancer. Ann Thorac Surg. 2014;97:980–6.

    Article  Google Scholar 

  5. Gonfiotti A, Bongiolatti S, Bertolaccini L, Viggiano D, Solli P, Droghetti A, et al. Thoracoscopic lobectomy for locally advanced-stage non-small cell lung cancer is a feasible and safe approach: analysis from multi-institutional national database. J Vis Surg 2017; 3:160. https://doi.org/10.21037/jovs.2017.09.06.eCollection 2017.

  6. Yang CJ, Nwosu A, Mayne NR, Wang Y, Raman V, Meyerhoff RR, et al. A minimally invasive approach to lobectomy after induction therapy does not compromise survival. Ann Thorac Surg. 2020;109:1503–11.

    Article  Google Scholar 

  7. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM Classification for lung cancer. J Thorac Oncol. 2016;11:39–51.

    Article  Google Scholar 

  8. Bhattacharyya N. Contemporary staging and prognosis for primary tracheal malignancies: A population-based analysis. Otolaryngol Head Neck Surg. 2004;131:639–42.

    Article  Google Scholar 

  9. Nakanishi R, Fujino Y, Oka S, Odate S. Video-assisted thoracic surgery involving major pulmonary resection for central tumors. Surg Endosc. 2010;24:161–9.

    Article  Google Scholar 

  10. Nakanishi R, Yamashita T, Muranaka K, Shinohara K. Surgical Technique: Thoracoscopic carinal resection and reconstruction in a patient with mucoepidermoid carcinoma. J Thorac Cardiovasc Surg. 2013;145:1134–5.

    Article  Google Scholar 

  11. Nakanishi R, Yamashita T, Oka S. Initial experience of video-assisted thoracic surgery lobectomy with partial removal of the pulmonary artery. Interact Cardiovasc Thorac Surg. 2008;7:996–1000.

    Article  Google Scholar 

  12. Demmy TL, Yendamuri S, Hennon MW, Dexter EU, Picone AL, Nwogu C. Thoracoscopic maneuvers for chest wall resection and reconstruction. J Thorac Cardiovasc Surg. 2012;144:S52–7.

    Article  Google Scholar 

  13. National Cancer Institute Cancer Therapy Evaluation Program. Available at https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf

  14. Chen K, Wang X, Yang F, Li J, Jiang G, Liu J, et al. Propensity-matched comparison of video-assisted thoracoscopic with thoracotomy lobectomy for locally advanced non-small cell lung cancer. J Thorac Cardiovasc Surg 2017; 153:967–76. e2.

  15. Yang CJ, Meyerhoff RR, Mayne NR, Singhapricha T, Toomey CB, Speicher PJ, et al. Long-term survival following open versus thoracoscopic lobectomy after preoperative chemotherapy for non-small cell lung cancer. Eur J Cardiothorac Surg. 2016;49:1615–23.

    Article  Google Scholar 

  16. Matsuoka K, Yamada T, Matsuoka T, Nagai S, Ueda M, Miyamoto Y. Video-assisted thoracoscopic surgery for lung cancer after induction therapy. Asian Cardiovasc Thorac Ann. 2018;26:698–714.

    Article  Google Scholar 

  17. Yang CJ, Yendamuri S, Mayne NR, Battoo A, Wang H, Meyerhoff RR, et al. The role of thoracoscopic pneumonectomy in the management of non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg 2019; 158:252–64. e2.

  18. Xie D, Deng J, Gonzalez-Rivas D, Zhu Y, Jiang L, Jiang G, et al. Comparison of video-assisted thoracoscopic surgery with thoracotomy in bronchial sleeve lobectomy for centrally located non-small cell lung cancer. J Thorac Cardiovasc Surg. 2021;161:403–13.

    Article  Google Scholar 

  19. Hanna JM, Berry MF, D’Amico TA. Contraindications of video-assisted thoracoscopic surgical lobectomy and determinants of conversion to open. J Thorac Dis. 2013;5:S182–9.

    PubMed  PubMed Central  Google Scholar 

  20. Shao W, Yin W, Wang W, Zhang X, Peng G, Chen X, et al. Glasses-free three-dimensional endoscopic bronchoplasty, arterioplasty, and angioplasty of the superior vena cava for the radical treatment of right middle upper lung cancer. J Thorac Dis. 2016;8:608–11.

    Article  Google Scholar 

  21. Tarui T, Ishikawa N, Ohtake H, Watanabe G. Totally endoscopic robotic resection of left atrial myxoma with persistent left superior vena cava. Interact Cardiovasc Thorac Surg. 2016;23:174–5.

    Article  Google Scholar 

  22. Veronesi G, Park B, Cerfolio R, Dylewski M, Toker A, Fontaine JP, et al. Robotic resection of stage III lung cancer: an international retrospective study. Eur J Cardiothorac Surg. 2018;54:912–9.

    Article  Google Scholar 

  23. Berry MF, Onaitis MW, Tong BC, Balderson SS, Harpole DH, D’Amico TA. Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection. Eur J Cardiothorac Surg. 2012;41:888–92.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Ryoichi Nakanishi, Katsuhiro Okuda, Keisuke Yokota, Tsutomu Tatematsu, Tadashi Sakane, Risa Oda, Osamu Kawano, Hiroshi Haneda & Satoru Moriyama

Authors
  1. Ryoichi Nakanishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katsuhiro Okuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keisuke Yokota
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tsutomu Tatematsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tadashi Sakane
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Risa Oda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Osamu Kawano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Haneda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Satoru Moriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katsuhiro Okuda.

Ethics declarations

Conflict of interest

Drs. Nakanishi, Okuda, Yokota, Tatematsu, Sakane, Oda, Kawano, Haneda, and Moriyama have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nakanishi, R., Okuda, K., Yokota, K. et al. Complex video-assisted thoracoscopic surgery lobectomy for locally advanced lung cancer: a prospective feasibility study. Surg Today 52, 1582–1590 (2022). https://doi.org/10.1007/s00595-022-02491-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-022-02491-x

Keywords

Search

Navigation