Abstract
Objective:Although video-assisted thoracic surgery (VATS) lobectomy has been demonstrated to be safe and technically feasible for nonsmall cell lung cancer, it is infrequently performed in most hospitals. As a result, there has been no clear long-term outcome regarding this procedure until recently.Methods:We retrospectively analyzed the results of patients suffering from lung cancer who underwent VATS lobectomy between March 1996 and December 2003. Perioperative data were collected and long-term outcomes were assessed by a 5-year census.Results:We successfully performed VATS procedures in 92 of 97 patients. The median operation time was 168 minutes and the median hospitalization period was 8.5 days. The median operative blood loss was 110 mL and the median drainage time was 3.3 days. The operative and postoperative (30-day) mortalities were 0% and 1.1%, respectively. The postoperative complications rate was 10.9%. The 5-year overall survival rates for stages I, II, and III or greater were 81.7%, 43.5%, and 22.2%, respectively.Conclusions:VATS lobectomy is a safe and feasible surgical procedure for nonsmall cell lung cancer and gives the same long-term outcomes as conventional open lobectomy.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References1.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;24:27–30.SugiK]]KanedaY]]EsatoKVideo-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer.World J Surg20002427-302.McKenna RJ Jr, Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 2006;81:421–426; discussion 425–426.3.Li WW, Lee RL, Lee TW, 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.LiWW]]LeeRL]]LeeTW&etal;The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy.Eur J Cardiothorac Surg200323390-3964.Tsang FH, Chung SS, Sihoe AD. Video-assisted thoracic surgery for bronchopulmonary sequestration. Interact Cardiovasc Thorac Surg 2006;5:424–426.TsangFH]]ChungSS]]SihoeADVideo-assisted thoracic surgery for bronchopulmonary sequestration.Interact Cardiovasc Thorac Surg20065424-4265.Shiraishi T, Shirakusa T, Miyoshi T, et al. A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer–technique, feasibility, and advantages. Thorac Cardiovasc Surg 2006;54:202–207.ShiraishiT]]ShirakusaT]]MiyoshiT&etal;A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer–technique, feasibility, and advantages.Thorac Cardiovasc Surg200654202-2076.Oda M, Ishikawa N, Tsunezuka Y, et al. Closed three-port anatomic lobectomy with systematic nodal dissection for lung cancer. Surg Endosc 2007;21:1464–1465.OdaM]]IshikawaN]]TsunezukaY&etal;Closed three-port anatomic lobectomy with systematic nodal dissection for lung cancer.Surg Endosc2007211464-14657.Tajiri M, Maehara T, Nakayama H, et al. Decreased invasiveness via two methods of thoracoscopic lobectomy for lung cancer, compared with open thoracotomy. Respirology 2007;12:207–211.TajiriM]]MaeharaT]]NakayamaH&etal;Decreased invasiveness via two methods of thoracoscopic lobectomy for lung cancer, compared with open thoracotomy.Respirology200712207-2118.McKenna RJ Jr, Houck WV. New approaches to the minimally invasive treatment of lung cancer. Curr Opin Pulm Med 2005;11:282–286.McKennaRJJr]]HouckWVNew approaches to the minimally invasive treatment of lung cancer.Curr Opin Pulm Med200511282-2869.Shiraishi T, Shirakusa T, Miyoshi T, et al. A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer—technique, feasibility, and advantages. Thorac Cardiovasc Surg 2006;54:202–207.ShiraishiT]]ShirakusaT]]MiyoshiT&etal;A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer—technique, feasibility, and advantages.Thorac Cardiovasc Surg200654202-20710.Haraguchi S, Koizumi K, Hatori N, et al. Postoperative respiratory complications of video-assisted thoracic surgery for lung cancer. J Nippon Med Sch 2004;71:30–34.HaraguchiS]]KoizumiK]]HatoriN&etal;Postoperative respiratory complications of video-assisted thoracic surgery for lung cancer.J Nippon Med Sch20047130-3411.Sedrakyan A, van der Meulen J, Lewsey J, et al. Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials. BMJ 2004;329:1008.SedrakyanA]]van der MeulenJ]]LewseyJ&etal;Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials.BMJ2004329100812.Mahtabifard A, DeArmond DT, Fuller CB, et al. Video-assisted thoracoscopic surgery lobectomy for stage I lung cancer. Thorac Surg Clin 2007;17:223–231.MahtabifardA]]DeArmondDT]]FullerCB&etal;Video-assisted thoracoscopic surgery lobectomy for stage I lung cancer.Thorac Surg Clin200717223-23113.Shigemura N, Yim AP. Variation in the approach to VATS lobectomy: effect on the evaluation of surgical morbidity following VATS lobectomy for the treatment of stage I non-small cell lung cancer. Thorac Surg Clin 2007;17:233–239.ShigemuraN]]YimAPVariation in the approach to VATS lobectomy: effect on the evaluation of surgical morbidity following VATS lobectomy for the treatment of stage I non-small cell lung cancer.Thorac Surg Clin200717233-23914.Yim AP, Wan S, Lee TW, et al. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 2000;70:243–247.YimAP]]WanS]]LeeTW&etal;VATS lobectomy reduces cytokine responses compared with conventional surgery.Ann Thorac Surg200070243-24715.Nagahiro I, Andou A, Aoe M, et al. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg2001;72:362–365.NagahiroI]]AndouA]]AoeM&etal;Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure.Ann Thorac Surg200172362-36516.Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy reduces cytokine production more than conventional open lobectomy. Jpn J Thorac Cardiovasc Surg 2000;48:161–165.SugiK]]KanedaY]]EsatoKVideo-assisted thoracoscopic lobectomy reduces cytokine production more than conventional open lobectomy.Jpn J Thorac Cardiovasc Surg200048161-16517.West D, Rashid S, Dunning J. Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobectomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg 2007;6:110–116.WestD]]RashidS]]DunningJDoes video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobectomy for non-small cell carcinoma of the lung?Interact Cardiovasc Thorac Surg20076110-11618.Petersen RP, Pham D, Toloza EM, et al. Thoracoscopic lobectomy: a safe and effective strategy for patients receiving induction therapy for non-small cell lung cancer. Ann Thorac Surg 2006;82:214–218.PetersenRP]]PhamD]]TolozaEM&etal;Thoracoscopic lobectomy: a safe and effective strategy for patients receiving induction therapy for non-small cell lung cancer.Ann Thorac Surg200682214-21819.Shaw JP, Dembitzer FR, Wisnivesky JP, et al. Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac Surg 2008;85:S705–S709.ShawJP]]DembitzerFR]]WisniveskyJP&etal;Video-assisted thoracoscopic lobectomy: state of the art and future directions.Ann Thorac Surg200885S705-S70920.Solaini L, Prusciano F, Bagioni P, et al. Video-assisted thoracic surgery major pulmonary resections. Present experience. Eur J Cardiothorac Surg 2001;20:437–442.SolainiL]]PruscianoF]]BagioniP&etal;Video-assisted thoracic surgery major pulmonary resections. Present experience.Eur J Cardiothorac Surg200120437-442
