Advertisement

Minimally Invasive Approaches to Lung Cancer

  • David P. Mason
  • Sudish C. Murthy
  • Jang Wen Su
  • Thomas W. Rice
Chapter

Abstract

Minimally invasive thoracic surgical techniques appear to reduce important morbidity and facilitate return to normal activity when compared with standard open approaches [1–3]. Mechanisms for this benefit likely include reduction in pain, earlier ambulation, and decreased inflammatory response to injury [3–6]. Before such techniques are routinely adopted, however, it is incumbent upon thoracic surgeons to demonstrate that therapeutic benefit of the procedure is not compromised. For resection of lung cancer, this means there must be comparable completeness of resection with appropriate lymph node sampling or lymphadenectomy [2, 7–9].

Keywords

Pulmonary Artery Pulmonary Vein Malignant Pleural Effusion Lobe Bronchus Inferior Pulmonary Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

Supported by the Daniel and Karen Lee Endowed Chair in Thoracic Surgery, Cleveland Clinic, Cleveland, OH.

References

  1. 1.
    Whitson BA, Andrade RS, Boettcher A et al (2007) Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer. Ann Thorac Surg 83(6):1965–1970PubMedCrossRefGoogle Scholar
  2. 2.
    Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA (2008) Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 86(6):2008–2016, discussion 16–18PubMedCrossRefGoogle Scholar
  3. 3.
    Grogan EL, Jones DR (2008) VATS lobectomy is better than open thoracotomy: what is the evidence for short-term outcomes? Thorac Surg Clin 18(3):249–258PubMedCrossRefGoogle Scholar
  4. 4.
    Yim AP, Wan S, Lee TW, Arifi AA (2000) VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 70(1):243–247PubMedCrossRefGoogle Scholar
  5. 5.
    Ng CS, Wan S, Hui CW et al (2007) Video-assisted thoracic surgery lobectomy for lung cancer is associated with less immunochemokine disturbances than thoracotomy. Eur J Cardiothorac Surg 31(1):83–87PubMedCrossRefGoogle Scholar
  6. 6.
    Ng CS, Lee TW, Wan S et al (2005) Thoracotomy is associated with significantly more profound suppression in lymphocytes and natural killer cells than video-assisted thoracic surgery following major lung resections for cancer. J Invest Surg 18(2):81–88PubMedCrossRefGoogle Scholar
  7. 7.
    Sagawa M, Sato M, Sakurada A et al (2002) A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery: can it be perfect? Ann Thorac Surg 73(3):900–904PubMedCrossRefGoogle Scholar
  8. 8.
    Kaseda S, Hangai N, Yamamoto S, Kitano M (1997) Lobectomy with extended lymph node dissection by video-assisted thoracic surgery for lung cancer. Surg Endosc 11(7):703–706PubMedCrossRefGoogle Scholar
  9. 9.
    Watanabe A, Koyanagi T, Ohsawa H et al (2005) Systematic node dissection by VATS is not inferior to that through an open thoracotomy: a comparative clinicopathologic retrospective study. Surgery 138(3):510–517PubMedCrossRefGoogle Scholar
  10. 10.
    Kaiser D, Ennker IC, Hartz C (1993) Video-assisted thoracoscopic surgery–indications, results, complications, and contraindications. Thorac Cardiovasc Surg 41(6):330–334PubMedCrossRefGoogle Scholar
  11. 11.
    Sedrakyan A, van der Meulen J, Lewsey J, Treasure T (2004) Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials. BMJ 329(7473):1008PubMedCrossRefGoogle Scholar
  12. 12.
    Nakamura H (2007) Controversies in thoracoscopic lobectomy for lung cancer. Ann Thorac Cardiovasc Surg 13(4):225–227PubMedGoogle Scholar
  13. 13.
    Nicastri DG, Wisnivesky JP, Litle VR et al (2008) Thoracoscopic lobectomy: report on safety, discharge independence, pain, and chemotherapy tolerance. J Thorac Cardiovasc Surg 135(3):642–647PubMedCrossRefGoogle Scholar
  14. 14.
    Kirby TJ, Mack MJ, Landreneau RJ, Rice TW (1995) Lobectomy–video-assisted thoracic surgery versus muscle-sparing thoracotomy. A randomized trial. J Thorac Cardiovasc Surg 109(5):997–1001, discussion 2PubMedCrossRefGoogle Scholar
  15. 15.
    Swanson SJ, Herndon JE 2nd, D’Amico TA et al (2007) Video-assisted thoracic surgery lobectomy: report of CALGB 39802 – a prospective, multi-institution feasibility study. J Clin Oncol 25(31):4993–4997PubMedCrossRefGoogle Scholar
  16. 16.
    McKenna RJ Jr (2008) Complications and learning curves for video-assisted thoracic surgery lobectomy. Thorac Surg Clin 18(3):275–280PubMedCrossRefGoogle Scholar
  17. 17.
    Reed MF, Lucia MW, Starnes SL, Merrill WH, Howington JA (2008) Thoracoscopic lobectomy: introduction of a new technique into a thoracic surgery training program. J Thorac Cardiovasc Surg 136(2):376–381PubMedCrossRefGoogle Scholar
  18. 18.
    Wan IY, Thung KH, Hsin MK, Underwood MJ, Yim AP (2008) Video-assisted thoracic surgery major lung resection can be safely taught to trainees. Ann Thorac Surg 85(2):416–419PubMedCrossRefGoogle Scholar
  19. 19.
    Ng T, Ryder BA (2006) Evolution to video-assisted thoracic surgery lobectomy after training: initial results of the first 30 patients. J Am Coll Surg 203(4):551–557PubMedCrossRefGoogle Scholar
  20. 20.
    McKenna RJ Jr, Houck W, Fuller CB (2006) Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 81(2):421–425, discussion 5–6PubMedCrossRefGoogle Scholar
  21. 21.
    Flores RM, Alam N (2008) Video-assisted thoracic surgery lobectomy (VATS), open thoracotomy, and the robot for lung cancer. Ann Thorac Surg 85(2):S710–S715PubMedCrossRefGoogle Scholar
  22. 22.
    Shaw JP, Dembitzer FR, Wisnivesky JP et al (2008) Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac Surg 85(2):S705–S709PubMedCrossRefGoogle Scholar
  23. 23.
    Shigemura N, Akashi A, Funaki S et al (2006) 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 132(3):507–512PubMedCrossRefGoogle Scholar
  24. 24.
    Alam N, Flores RM (2007) Video-assisted thoracic surgery (VATS) lobectomy: the evidence base. JSLS 11(3):368–374PubMedGoogle Scholar
  25. 25.
    Suzuki K, Nagai K, Yoshida J et al (1999) Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest 115(2):563–568PubMedCrossRefGoogle Scholar
  26. 26.
    Gonfiotti A, Davini F, Vaggelli L et al (2007) Thoracoscopic localization techniques for patients with solitary pulmonary nodule: hookwire versus radio-guided surgery. Eur J Cardiothorac Surg 32(6):843–847PubMedCrossRefGoogle Scholar
  27. 27.
    Sortini D, Feo CV, Carcoforo P et al (2005) Thoracoscopic localization techniques for patients with solitary pulmonary nodule and history of malignancy. Ann Thorac Surg 79(1):258–262, discussion 62PubMedCrossRefGoogle Scholar
  28. 28.
    Burdine J, Joyce LD, Plunkett MB, Inampudi S, Kaye MG, Dunn DH (2002) Feasibility and value of video-assisted thoracoscopic surgery wedge excision of small pulmonary nodules in patients with malignancy. Chest 122(4):1467–1470PubMedCrossRefGoogle Scholar
  29. 29.
    Stiles BM, Altes TA, Jones DR et al (2006) Clinical experience with radiotracer-guided thoracoscopic biopsy of small, indeterminate lung nodules. Ann Thorac Surg 82(4):1191–1196, discussion 6–7PubMedCrossRefGoogle Scholar
  30. 30.
    Watanabe K, Nomori H, Ohtsuka T, Kaji M, Naruke T, Suemasu K (2006) Usefulness and complications of computed tomography-guided lipiodol marking for fluoroscopy-assisted thoracoscopic resection of small pulmonary nodules: experience with 174 nodules. J Thorac Cardiovasc Surg 132(2):320–324PubMedCrossRefGoogle Scholar
  31. 31.
    Dendo S, Kanazawa S, Ando A et al (2002) Preoperative localization of small pulmonary lesions with a short hook wire and suture system: experience with 168 procedures. Radiology 225(2):511–518PubMedCrossRefGoogle Scholar
  32. 32.
    Warren WH, Faber LP (1994) Segmentectomy versus lobectomy in patients with stage I pulmonary carcinoma. Five-year survival and patterns of intrathoracic recurrence. J Thorac Cardiovasc Surg 107(4):1087–1093, discussion 93–94PubMedGoogle Scholar
  33. 33.
    Ginsberg RJ, Rubinstein LV (1995) Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 60(3):615–622, discussion 22–23PubMedCrossRefGoogle Scholar
  34. 34.
    Kodama K, Doi O, Higashiyama M, Yokouchi H (1997) Intentional limited resection for selected patients with T1 N0 M0 non-small-cell lung cancer: a single-institution study. J Thorac Cardiovasc Surg 114(3):347–353PubMedCrossRefGoogle Scholar
  35. 35.
    Shennib H, Bogart J, Herndon JE et al (2005) Video-assisted wedge resection and local radiotherapy for peripheral lung cancer in high-risk patients: the Cancer and Leukemia Group B (CALGB) 9335, a phase II, multi-institutional cooperative group study. J Thorac Cardiovasc Surg 129(4):813–818PubMedCrossRefGoogle Scholar
  36. 36.
    Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N (2006) Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg 132(4):769–775PubMedCrossRefGoogle Scholar
  37. 37.
    El-Sherif A, Fernando HC, Santos R et al (2007) Margin and local recurrence after sublobar resection of non-small cell lung cancer. Ann Surg Oncol 14(8):2400–2405PubMedCrossRefGoogle Scholar
  38. 38.
    McKenna RJ Jr, Mahtabifard A, Yap J et al (2008) Wedge resection and brachytherapy for lung cancer in patients with poor pulmonary function. Ann Thorac Surg 85(2):S733–S736PubMedCrossRefGoogle Scholar
  39. 39.
    Yoshikawa K, Tsubota N, Kodama K, Ayabe H, Taki T, Mori T (2002) Prospective study of extended segmentectomy for small lung tumors: the final report. Ann Thorac Surg 73(4):1055–1058, discussion 8–9PubMedCrossRefGoogle Scholar
  40. 40.
    Okada M, Yoshikawa K, Hatta T, Tsubota N (2001) Is segmentectomy with lymph node assessment an alternative to lobectomy for non-small cell lung cancer of 2 cm or smaller? Ann Thorac Surg 71(3):956–960, discussion 61PubMedCrossRefGoogle Scholar
  41. 41.
    Yamanaka A, Hirai T, Fujimoto T, Ohtake Y, Konishi F (2000) Analyses of segmental lymph node metastases and intrapulmonary metastases of small lung cancer. Ann Thorac Surg 70(5):1624–1628PubMedCrossRefGoogle Scholar
  42. 42.
    Bernard A, Brondel L, Arnal E, Favre JP (2006) Evaluation of respiratory muscle strength by randomized controlled trial comparing thoracoscopy, transaxillary thoracotomy, and posterolateral thoracotomy for lung biopsy. Eur J Cardiothorac Surg 29(4):596–600PubMedCrossRefGoogle Scholar
  43. 43.
    Yendamuri S, Komaki RR, Correa AM et al (2007) Comparison of limited surgery and three-dimensional conformal radiation in high-risk patients with stage I non-small cell lung cancer. J Thorac Oncol 2(11):1022–1028PubMedCrossRefGoogle Scholar
  44. 44.
    Iwasaki A, Shirakusa T, Shiraishi T, Yamamoto S (2004) Results of video-assisted thoracic surgery for stage I/II non-small cell lung cancer. Eur J Cardiothorac Surg 26(1):158–164PubMedCrossRefGoogle Scholar
  45. 45.
    Rankin S (2008) PET/CT for staging and monitoring non small cell lung cancer. Cancer Imaging 8(Suppl A):S27–S31PubMedCrossRefGoogle Scholar
  46. 46.
    Kernstine KH, Stanford W, Mullan BF et al (1999) PET, CT, and MRI with Combidex for mediastinal staging in non-small cell lung carcinoma. Ann Thorac Surg 68(3):1022–1028PubMedCrossRefGoogle Scholar
  47. 47.
    Lardinois D, Weder W, Hany TF et al (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348(25):2500–2507PubMedCrossRefGoogle Scholar
  48. 48.
    Shim SS, Lee KS, Kim BT et al (2005) Non-small cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging. Radiology 236(3):1011–1019PubMedCrossRefGoogle Scholar
  49. 49.
    Ferguson MK, Little L, Rizzo L et al (1988) Diffusing capacity predicts morbidity and mortality after pulmonary resection. J Thorac Cardiovasc Surg 96(6):894–900PubMedGoogle Scholar
  50. 50.
    Ferguson MK, Reeder LB, Mick R (1995) Optimizing selection of patients for major lung resection. J Thorac Cardiovasc Surg 109(2):275–281, discussion 81–83PubMedCrossRefGoogle Scholar
  51. 51.
    Filaire M, Bedu M, Naamee A et al (1999) Prediction of hypoxemia and mechanical ventilation after lung resection for cancer. Ann Thorac Surg 67(5):1460–1465PubMedCrossRefGoogle Scholar
  52. 52.
    Kocabas A, Kara K, Ozgur G, Sonmez H, Burgut R (1996) Value of preoperative spirometry to predict postoperative pulmonary complications. Respir Med 90(1):25–33PubMedCrossRefGoogle Scholar
  53. 53.
    Mazzone PJ, Arroliga AC (2005) Lung cancer: preoperative pulmonary evaluation of the lung resection candidate. Am J Med 118(6):578–583PubMedCrossRefGoogle Scholar
  54. 54.
    Garzon JC, Ng CS, Sihoe AD et al (2006) Video-assisted thoracic surgery pulmonary resection for lung cancer in patients with poor lung function. Ann Thorac Surg 81(6):1996–2003PubMedCrossRefGoogle Scholar
  55. 55.
    Cattaneo SM, Park BJ, Wilton AS et al (2008) Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg 85(1):231–235, discussion 5–6PubMedCrossRefGoogle Scholar
  56. 56.
    Jaklitsch MT, DeCamp MM Jr, Liptay MJ et al (1996) Video-assisted thoracic surgery in the elderly. A review of 307 cases. Chest 110(3):751–758PubMedCrossRefGoogle Scholar
  57. 57.
    Kim K, Rice TW, Murthy SC et al (2004) Combined bronchoscopy, mediastinoscopy, and thoracotomy for lung cancer: who benefits? J Thorac Cardiovasc Surg 127(3):850–856PubMedCrossRefGoogle Scholar
  58. 58.
    Sugiura S, Ando Y, Minami H, Ando M, Sakai S, Shimokata K (1997) Prognostic value of pleural effusion in patients with non-small cell lung cancer. Clin Cancer Res 3(1):47–50PubMedGoogle Scholar
  59. 59.
    Mott FE, Sharma N, Ashley P (2001) Malignant pleural effusion in non-small cell lung cancer–time for a stage revision? Chest 119(1):317–318PubMedCrossRefGoogle Scholar
  60. 60.
    Dresler CM, Olak J, Herndon JE 2nd et al (2005) Phase III intergroup study of talc poudrage vs. talc slurry sclerosis for malignant pleural effusion. Chest 127(3):909–915PubMedCrossRefGoogle Scholar
  61. 61.
    Murthy SC, Okereke I, Mason DP, Rice TW (2006) A simple solution for complicated pleural effusions. J Thorac Oncol 1(7):697–700PubMedCrossRefGoogle Scholar
  62. 62.
    Putnam JB Jr, Walsh GL, Swisher SG et al (2000) Outpatient management of malignant pleural effusion by a chronic indwelling pleural catheter. Ann Thorac Surg 69(2):369–375PubMedCrossRefGoogle Scholar
  63. 63.
    Warren WH, Kim AW, Liptay MJ (2008) Identification of clinical factors predicting Pleurx catheter removal in patients treated for malignant pleural effusion. Eur J Cardiothorac Surg 33(1):89–94PubMedCrossRefGoogle Scholar
  64. 64.
    Kirby TJ, Rice TW (1993) Thoracoscopic lobectomy. Ann Thorac Surg 56(3):784–786PubMedCrossRefGoogle Scholar
  65. 65.
    Kirby TJ, Mack MJ, Landreneau RJ, Rice TW (1993) Initial experience with video-assisted thoracoscopic lobectomy. Ann Thorac Surg 56(6):1248–1252, discussion 52–53PubMedCrossRefGoogle Scholar
  66. 66.
    Onaitis MW, Petersen RP, Balderson SS et al (2006) Thoracoscopic lobectomy is a safe and versatile procedure: experience with 500 consecutive patients. Ann Surg 244(3):420–425PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • David P. Mason
    • 1
  • Sudish C. Murthy
    • 2
  • Jang Wen Su
    • 2
  • Thomas W. Rice
    • 3
    • 2
  1. 1.Department of Thoracic SurgeryCleveland ClinicClevelandUSA
  2. 2.Department of Thoracic and Cardiovascular SurgeryCleveland ClinicClevelandUSA
  3. 3.Cleveland Clinic Lerner College of Medicine, Cleveland ClinicClevelandUSA

Personalised recommendations