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Video-assisted thoracic surgery for lung cancer

Is it a feasible operation for stage I lung cancer?

Abstract

Objective|The objective of this study was to confirm the safety and feasibility of video-assisted thoracic surgery (VATS) for primary lung cancer and to compare prognoses with that of conventional procedures, and then to examine whether VATS would supplant a conventional thoracotomy for stage I lung cancer. Methods: From September 1995 through March 2002, 144 patients with primary lung cancer, included 118 patients with postoperative state I, underwent VATS lobectomy. We reviewed the previous cases whether they could be candidates for VATS lobectomy according to present indications. 166 cases were supposed to be candidates for VATS, and 121 cases of postoperative stage I disease were recruited into the “conventional thoracotomy” group. Results: There was no mortality or major complication except one case, and mean follow-up was 31.8 months in VATS. The number of removed lymph nodes was not significantly less than the number by conventional thoractomy (p=0.061). Five-year survival for patients with pathological stage IA adenocarcinoma was 92.4% (n=66) in VATS and 86.9% (n=50) in conventional thoracotomy, and a statistical significance could not be recognized (p=0.980). The length of hospital stay was significantly short in VATS lobectomy (p<0.0001). Conclusions: VATS lobectomy for stage I lung cancer can be performed safely with minimal morbidity, satisfying survival comparable with that of lobectomy through conventional thoractomy. VATS approach is a feasible surgical technique for patients with stage I lung cancer.

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References

  1. Stammberger U, Steinacher C, Hillinger S, Schmid RA, Kinsbergen T, Weder W. Early and long-term complaints following video-assisted thoracoscopic surgery: Evaluation in 173 patients. Eur J Cardiothorac Surg 2000; 18: 7–11.

    CAS  Article  PubMed  Google Scholar 

  2. McKenna RJ Jr, Wolf RK, Brenner M, Fischel RJ, Wurnig P. Is lobectomy by video-assisted thoracic surgery an adequate cancer operation? Ann Thorac Surg 1998; 66: 1903–8.

    Article  PubMed  Google Scholar 

  3. McKenna RJ Jr. The current status of video-assisted thoracic surgery lobectomy. Chest Surg Clin N Am 1998; 8: 775–85.

    PubMed  Google Scholar 

  4. McKenna RJ Jr, Fischel RJ, Wolf R, Wurnig P. Video-assisted thoracic surgery (VATS) lobectomy for bronchogenic carcinoma. Semin Thorac Cardiovasc Surg 1998; 10: 321–5.

    Article  PubMed  Google Scholar 

  5. Brown WT. Video-assisted thoracic surgery: The Miami experience. Semin Thorac Cardiovasc Surg 1998; 10: 305–12.

    CAS  Article  PubMed  Google Scholar 

  6. Andou A, Nagahiro I, Aoe M, Sano Y, Okabe K, Date H, et al. Thoracoscopic surgery for cStage IA non small cell lung cancer with emphasis on its prognosis (Eng abstr). J Jpn Soc Endosc Surg 2002; 7: 140–4.

    Google Scholar 

  7. Kaseda S, Aoki T, Hangai K. Better pulmonary function and prognosis with video-assisted thoracic surgery than with thoractomy. Ann Thorac Surg 2000; 70: 1644–6.

    CAS  Article  PubMed  Google Scholar 

  8. Kaseda S, Aoki T, Hangai N. Video-assisted thoracic surgery (VATS) lobectomy: The Japanese experience. Semin Thorac Cardiovasc Surg 1998; 10: 300–4.

    CAS  Article  PubMed  Google Scholar 

  9. Kawahara, K, Iwasaki, A, Shiraishi T, Okabayashi K, Shirakusa T. Video-assisted thoracoscopic lobectomy for treating lung cancer. Surg Laparosc Endosc 1997; 7: 219–22.

    CAS  Article  PubMed  Google Scholar 

  10. Shirakusa T. The current status of video-assisted thoracic surgery: On the operative indiction (Eng abstr). J Jpn Soc Endosc Surg 2002; 7: 105–9.

    Google Scholar 

  11. Tatsumi A, Kanemitsu N, Nakamura T, Shimizu Y. Bioabsorbable poly-L-lactide costal copatation pins and their clinical application in thoractomy. Ann Thorac Surg 1999; 67: 765–8.

    CAS  Article  PubMed  Google Scholar 

  12. Tovar EA, Roethe RA, Weissig MD, Lillie MJ, Dabbs-Moyer KS, Lloyd RE, et al. Muscle-sparing minithoracotomy with intercostal nerve cryoanalgesia: An improved method for major lung resections. Am Surg 1998; 64: 1109–15.

    CAS  PubMed  Google Scholar 

  13. 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: 712–8.

    CAS  Article  PubMed  Google Scholar 

  14. Sagawa M, Sato M, Sakurada A, Matsumura Y, Endo C, Handa M, et al. A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery: Can it be perfect? Ann Thorac Surg 2000; 73: 900–4.

    Article  Google Scholar 

  15. Lewis RJ, Caccavale RJ. Video-assisted thoracic surgical non-rib spreading simultaneously stapled lobectomy (VATS(n)SSL). Semin Thorac Cardiovasc Surg 1998; 10: 332–9.

    CAS  Article  PubMed  Google Scholar 

  16. Craig SR, Leaver HA, Yap PL, Pugh GC, Walker WS. Acute phase responses following minimal access and conventional responses following minimal access and conventional thoracic surgery. Eur J Cardiothorac Surg 2001; 20: 455–63.

    CAS  Article  PubMed  Google Scholar 

  17. Yim AP, Wan S, Lee TW, Arifi AA. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 2000; 70: 243–7.

    CAS  Article  PubMed  Google Scholar 

  18. Yamashita JI, Kurusu Y, Fujino N, Saisyoji T, Ogawa M. Detection of circulating tumor cells in patients with non-small cell lung cancer undergoing lobectomy by video-assisted thoracic surgery: A potential hazard for intraoperative hematogenous tumor cell dissemination. J Thorac Cardiovasc Surg 2000; 119: 899–90.

    CAS  Article  PubMed  Google Scholar 

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Tatsumi, A., Ueda, Y. Video-assisted thoracic surgery for lung cancer. Jpn J Thorac Caridovasc Surg 51, 646–650 (2003). https://doi.org/10.1007/s11748-003-0002-y

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  • DOI: https://doi.org/10.1007/s11748-003-0002-y

Key words

  • video-assisted thoracic surgery
  • video-assisted thoracic surgery lobectomy
  • lung cancer
  • lymph node dissection
  • five-year survival