Application of video-assisted thoracic surgery in the standard operation for lung tumors

Abstract

OBJECTIVE To evaluate the indication and short-term outcomes of video assisted thoracic surgery (VATS) for lung tumors. METHODS Data of 306 consecutive patients undergoing VATS pulmonary resection between were retrospectively reviewed. RESULTSThere were 7 patients who underwent open thoracotomy, accounting for 2.29% (7/306). The overall morbidity rate of complications and the mortality rate induced by VATS was 1.63% (5/306) and 0.33% (1/306), respectively. There were no significant differences in morbidity and mortality rate between the patients receiving the VATS and the patients receiving the OT. The overall hospitalization, postoperative length of stay (LOS) and chest tube duration in the VATS lobectomy group (n = 167) were shorter than those in the open thoracotomy (OT), but the operative time in the VATS group was longer than that in the OT group (n = 124). There were no signifi cant diff erences in the number of station of lymph nodal dissection (LND) and number of LND in pathological stage I between VATS group and OT group, but signifi cant diff erences were found in the number of station of LND and the number of LND in pathological stage II and stage IIIA between the 2 groups. Compared with those who underwent OT wedge resection (n = 72), the patients who underwent VATS wedge resection (n = 108) had shorter operative time, chest tube duration and hospital LOS, and there were no significant differences in morbidity of the complications and mortality between the 2 groups. CONCLUSION VATS lobectomy can be performed for patients with clinical stage I lung cancer (with tumor diameter smaller than 5 cm, without hilar and mediastinal lymph node enlargement). VATS lobectomy is superior to OT lobectomy in short-term outcomes, although further studies exploring long-term outcomes through longer follow-up is needed to determine the oncologic equivalency between the VATS and the open lobectomy. VATS is also superior to OT in pulmonary wedge resection.

Perioperative outcomes and long-term survival in clinically early-stage thymic malignancies: video-assisted thoracoscopic thymectomy versus open approaches

“…Median sternotomy has traditionally been regarded as the standard approach for surgical treatment of thymic malignancies, while open lateral thoracotomy is sometimes used as an alternative for special cases such as large tumors that deviates into the pleural cavity (6,7). Minimally invasive approaches, typically VATS thymectomy, were introduced only recently but have been gaining popularity very rapidly (8)(9)(10). Similarly in China, a continuously increased proportion of patients with early-stage thymic tumors have been treated with VATS thymectomy.…”

Comparison of short‐term outcomes and three yearsurvival between total minimally invasiveMcKeown and dual‐incision esophagectomy

“…The details of total MIME have been described in our previous study . In short, the patient is placed in the left lateral decubitus position.…”

A propensity matched comparison of effects between video assisted thoracoscopic single-port, two-port and three-port pulmonary resection on lung cancer

“…We started VATS single-port pulmonary resection since November 2014 (16). Single-port VATS pulmonary resection procedures were accomplished based on the techniques reported by Gonzalez-Rivas et al (10) and our previous experiences of VATS three-port pulmonary resection (16,20). VATS single-port pulmonary resection procedures were performed as follows.…”

“…The details of VATS three-port pulmonary resection procedures were reported previously (16,20). Generally, one port for viewing was done at 7th intercostal spaces on the middle axillary line, and two ports for working on the anterior axillary line and posterior axillary line respectively, on which the intercostal spaces in detail according to the location of lesion by CT. Thoracoscopic segmentectomy began with identification and ligation of segmental vein.…”