Skip to main content
SpringerLink
Log in

Video-assisted thoracic surgery lobectomy for lung cancer: the point at issue

  • Current Topics Review
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Among the four subjects addressed in this article, the definition of video-assisted thoracic surgery (VATS) lobectomy is fundamentally the point at issue, which leads to various obstacles for upcoming clinical trials. It is strongly expected that VATS lobectomy will be identified as a standard operation for primary lung cancer with confirmed clinical evidence. Standard surgical procedure with a certain oncological validity for lung cancer should be minimally invasive, safe, and technically simple for general thoracic surgeons. In conclusion, most patients with resectable lung cancer will be able to benefit from a validated painless VATS lobectomy in the near future.

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

Similar content being viewed by others

References

  1. McKenna RJ, Hook W, Fuller CB (2006) Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 2006;81:1903–1908.

    Article  Google Scholar 

  2. Onaitis MW, Petersen RP, Balderson SS, Toloza E, Burfeind WR, Harpole DH, et al. Thoracoscopic lobectomy is a safe and versatile procedure, experience with 500 consecutive patients. Ann Surg 2006;244:420–425.

    PubMed  Google Scholar 

  3. Kim K, Kim K, Park JS, Chang SW, Choi YS, Kim J, et al. Video-assisted thoracic surgery lobectomy: single institutional experience with 704 cases. Ann Thorac Surg 2010;89:S2118–S2122.

    Article  PubMed  Google Scholar 

  4. Swanson SJ, Herndon JE, D’Amico TA, Demmy TL, McKenna RJ Jr, Green MR, et al. Video-assisted thoracic surgery lobectomy: report of CALGB 39802—a prospective, multi-institution feasibility study. J Clin Oncol 2007;25: 4993–4997.

    Article  PubMed  Google Scholar 

  5. Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA. Surgery for early stage non-small cell lung cancer: systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 2008;86:2008–2018.

    Article  PubMed  Google Scholar 

  6. Yan TD, Black D, Bannon PG, McCaughan BC. Systematic review and mea-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol 2009;27:2553–2562.

    Article  PubMed  Google Scholar 

  7. Paul S, Altorki NK, Sheng S, Lee PC, Harpole DH, Onaitis MW, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg 2010;139:366–378.

    Article  PubMed  Google Scholar 

  8. Yim AP, Landreneau RJ, Izzat MB, Fung ALK, Wan S. Is video-assisted thoracoscopic lobectomy a unified approach? Ann Thorac Surg 1998;66:1155–1158.

    Article  PubMed  CAS  Google Scholar 

  9. Yamashita Y, Mukaida H, Takiyama W, Hirabayashi N, Hisamatsu K, Saeki S, et al. Minimally invasive video-assisted thoracoscopic lobectomy for better clinical outcomes in peripheral T1N0 lung cancer. Int Surg 2008;93:226–232.

    PubMed  CAS  Google Scholar 

  10. Shigemura N, Akashi A, Funaki S, Nakagiri T, Inoue M, Sawabata N, et al. Long-term outcomes after a variety of video-assisted thoracoscopic lobectomy approaches for clinical stage IA lung cancer: a multi-institutional study. J Thorac Cardiovasc Surg 2006;132:507–512.

    Article  PubMed  Google Scholar 

  11. Okada M, Sakamoto T, Yuki T, Mimura T, Miyoshi K, Tsubota N. Hybrid surgical approach of video-assisted minithoracotomy for lung cancer: significance of direct visualization on quality of surgery. Chest 2005;128:2696–2701.

    Article  PubMed  Google Scholar 

  12. Craig SR, Leaver HA, Yap PL, Pugh GC, Walker WS. Acute phase responses following minimal access and conventional thoracic surgery. Eur J Cardiovasc Surg 2001;20:455–463.

    Article  CAS  Google Scholar 

  13. Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg 2000;24:27–31.

    Article  PubMed  CAS  Google Scholar 

  14. Shigemura N, Akashi A, Nakagiri T, Ohta M, Matsuda H. Complete vs. assisted thoracoscopic approach: a prospective randomized trial comparing a variety of video-assisted thoracoscopic lobectomy techniques. Surg Endosc 2004;18:1492–1497.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  16. Giudecelli R, Thomas P, Lonjon T, Ragni J, Bulgare JC, Ottomani R, et al. Major pulmonary resection by video assisted mini-thoracotomy: initial experience in 35 patients. Eur J Cardiothorac Surg 1994;8:254–258.

    Article  Google Scholar 

  17. Walker WS. Video-assisted thoracic surgery (VATS) lobectomy: the Edinburgh experience. Semin Thorac Cardiovasc Surg 1998;10:291–299.

    PubMed  CAS  Google Scholar 

  18. Sugiura H, Morikawa T, Kaji M, Sasamura Y, Kondo S, Katoh H. Long-term benefits for the quality of life after videoassisted thoracoscopic lobectomy in patients with lung cancer. Surg Laparosc Endosc Percutan Tech 1999;9:403–408.

    PubMed  CAS  Google Scholar 

  19. Yamashita Y, Mukaida H, Moritani C, Egawa H, Kaneko M. Retrospective comparison of clinical outcomes of thoracoscopic VATS lobectomy for stage IA primary lung cancer. Jpn J Lung Cancer 2006;46:337–343.

    Article  Google Scholar 

  20. Nakata M, Saeki H, Yokoyama N, Kurita A, Takiyama W, Takashima S. Pulmonary function after lobectomy: videoassisted thoracic surgery versus thoracotomy. Ann Thorac Surg 2000;70:938–941.

    Article  PubMed  CAS  Google Scholar 

  21. Nomori H, Ohtsuka T, Horio H, Naruke T, Suemasu K. Difference in the impairment of vital capacity and 6-minute walking after a lobectomy performed by thoracoscopic surgery, an anterior limited thoracotomy, an anteroaxillary thoracotomy, and a posterolateral thoracotomy. Surg Today 2003;33:7–12.

    Article  PubMed  Google Scholar 

  22. Li WW, Lee RL, Lee TW, Ng CS, Sihoe AD, Wan IY, et al. The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy. Eur J Cardiothorac Surg 2003;23:390–396.

    Article  PubMed  Google Scholar 

  23. Landreneau RJ, Mack MJ, Hazelrigg SR, Naunheim K, Dowling RD, Ritter P, et al. Prevalence of chronic pain after pulmonary resection by thoracotomy or video-assisted thoracic surgery. J Thorac Cardiovasc Surg 1994;107:1079–1086.

    PubMed  CAS  Google Scholar 

  24. Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure: Ann Thorac Surg. 2001;72:362–365.

    Article  PubMed  CAS  Google Scholar 

  25. Yim AP, Wan S, Lee TW, Arifi AA. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 2000;70:243–247.

    Article  PubMed  CAS  Google Scholar 

  26. Anup R, Barasubramanian KA. Surgical stress and the gastrointestinal tract. J Surg Res 2000;92:291–300.

    Article  PubMed  CAS  Google Scholar 

  27. Yim AP, Wan S, Lee TW, Arifi AA. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 2000;70:243–247.

    Article  PubMed  CAS  Google Scholar 

  28. Craig SR, Leaver HA, Yap PL Pugh GC, Walker WS. Acute phase responses following minimal access and conventional thoracic surgery. Eur J Cardiothorac Surg 2001;20:455–463.

    Article  PubMed  CAS  Google Scholar 

  29. Ng CS, Wan S, Hui CW, Lee TW, Underwood ML, Yim AP. Video-assisted thoracic surgery for early stage lung cancer: can short-term immunological advantages improve long-term survival? Ann Thorac Cardiovasc Surg 2006;12:308–312.

    PubMed  Google Scholar 

  30. Whitson BA, D’Cunha J, Andrade RS, Kelly RF, Groth SS, Wu B, et al. Thoracoscopic versus thoracotomy approaches to lobectomy: differential impairment of cellular immunity. Ann Thorac Surg 2008;86:1735–1744.

    Article  PubMed  Google Scholar 

  31. Hirai T, Matsumoto H, Yamashita K, Urakami A, Iki K, Yamamura Y, et al. Surgical oncotaxis: excessive surgical stress and postoperative complications contribute to enhancing tumor metastasis, resulting in a poor prognosis for cancer patients. Ann Thorac Cardiovasc Surg 2005;11:4–6.

    PubMed  Google Scholar 

  32. Watanabe A, Koyanagi T, Ohsawa H, Mawatari T, Nakashima S, Takahashi N, et al. Systematic node dissection by VATS is not inferior to that through an open thoracotomy: a comparative clinicopathologic retrospective study. Surgery 2005;138: 510–517.

    Article  PubMed  Google Scholar 

  33. Inada K, Shirakusa T, Yoshinaga Y, Yoneda S, Shiraishi T, Okabayashi K, et al. The role of video-assisted thoracic surgery for the treatment of lung cancer: lung lobectomy by thoracoscopic versus the standard thoracotomy approach. Int Surg 2000;85:6–12.

    PubMed  CAS  Google Scholar 

  34. Sagawa M, Sato M, Sakurada A, Matsumura Y, Endo C, Hanada 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 2002;73:900–904.

    Article  PubMed  Google Scholar 

  35. Hoksch B, Ablassmaier B, Walter M, Muller JM. Radical thoracoscopic lobectomy with lymphadenectomy in a cadaver model. Can J Surg 2002;45:376–380.

    PubMed  Google Scholar 

  36. Asamura H, Nakayama H, Kondo H, Tsuchiya R, Naruke T. Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small-cell lung carcinomas: are these carcinomas candidates for video-assisted lobectomy? J Thorac Cardiovasc Surg 1996;111:1125–1134.

    Article  PubMed  CAS  Google Scholar 

  37. Downey Raj, McCormack P, Locicero J III. Dissemination of malignant tumors after video-assisted thoracic surgery: a report of twenty-one cases-the Video-assisted Thoracic Surgery Study Group. J Thorac Cardiovasc Surg 1997;114:300–302.

    Google Scholar 

  38. 9th Nationwide survey of endoscopic surgery in Japan. J Jpn Soc Endosc Surg 2008;13:362.

  39. Roviano G, Varoli F, Vergani C, Nucca O, Maciocco M, Grignani F. Long-term survival after videothoracoscopic lobectomy for stage I lung cancer. Chest 2004;126:725–732.

    Article  Google Scholar 

  40. Sawada S, Komori E, Yamashita M. Very long-term outcomes of video-assisted thoracoscopic surgery for lung cancer. Surg Endosc 2008;22:2407–2411.

    Article  PubMed  Google Scholar 

  41. Yamamoto K, Osumi A, Imanishi N, Matsuoka K, Ueda M, Miyamoto Y. Long-term survival after video-assisted thoracic surgery lobectomy for primary lung cancer. Ann Thorac Surg 2010;89:353–359.

    Article  PubMed  Google Scholar 

  42. Petersen RP, Pham DK, Burfeind WR, Hanish SI, Toloza EM, Harpole DH, et al. Thoracoscopic lobectomy facilitates the delivery of chemotherapy after resection for lung cancer. Ann Thorac Surg 2006;83:1245–1250.

    Article  Google Scholar 

  43. Nicastri DG, Wisnivesky JP, Litle VR, Yun J, Chin C, Dembitzer FR, et al. Thoracoscopic lobectomy: report on safety, discharge independence, pain, and chemotherapy tolerance. J Thorac Cardiovasc Surg 2008;135:642–647.

    Article  PubMed  Google Scholar 

  44. Ferguson J, Walker W. Developing a VATS lobectomy programme: can VATS lobectomy be taught? Eur J Cardiothorac Surg 2006;29:806–809.

    Article  PubMed  Google Scholar 

  45. Wan IY, Thung KH, Hsin MK, Underwood MJ, Yim AP. Video-assisted thoracic surgery major lung resection can be safely taught to trainees. Ann Thorac Surg 2008;85:416–419.

    Article  PubMed  Google Scholar 

  46. Reed MF, Lucia MW, Starnes SL, Merrill WH, Howington JA. Thoracoscopic lobectomy: introduction of a new technique into a thoracic surgery training program. J Thorac Cardiovasc Surg 2008;136:376–381.

    Article  PubMed  Google Scholar 

  47. Yamashita Y, Mukaida H, Egawa H, Murai H, Hamai K, Kaneko M. Learning curve of the minimally invasive VATS lobectomy for non-small lung cancer. Jpn J Lung Cancer 2008;48:681–687.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Thoracic Surgery, National Hospital Organization, Kure Medical Center/Chugoku Cancer Center, 3-1 Aoyamacho, Kure, 737-0023, Japan

    Yoshinori Yamashita, Hiroaki Harada & Keizo Misumi

Authors
  1. Yoshinori Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroaki Harada
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keizo Misumi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshinori Yamashita.

Additional information

This review was submitted at the invitation of the editorial committee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamashita, Y., Harada, H. & Misumi, K. Video-assisted thoracic surgery lobectomy for lung cancer: the point at issue. Gen Thorac Cardiovasc Surg 59, 164–168 (2011). https://doi.org/10.1007/s11748-010-0708-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-010-0708-6

Key words

Search

Navigation