Thoracoscopic lobectomy for the management of non-small cell lung cancer

Abstract

Surgical resection is the primary treatment for early-stage non-small cell lung cancer (NSCLC). While open thoracotomy is the most frequently performed approach for lobectomy, minimally invasive surgical resection is a safe and viable alternative. Thoracoscopic lobectomy, also termed video-assisted thoracoscopic surgery lobectomy, is defined as the anatomic resection of an entire lobe of the lung—including mediastinal lymph node dissection—using a thoracoscope and an access incision without using a mechanical retractor and spreading of the ribs. As the procedure has evolved and been studied, thoracoscopic lobectomy has been demonstrated to be a safe and oncologically effective strategy in the surgical management of patients with stage I or II NSCLC, as well as selected patients with stage III NSCLC after induction therapy. Advantages of this approach include less postoperative pain, shorter chest tube duration and subsequent length of stay, fewer overall complications, better compliance with adjuvant chemotherapy, faster return to full activity, and greater preservation of pulmonary function.