Clinical Outcomes of Video-Assisted Thoracoscopic Lobectomy

Tomaszek, Sandra; Cassivi, Stephen D.; Shen, K. Robert; Allen, Mark S.; Nichols, Francis C.; Deschamps, Claude; Wigle, Dennis A.

doi:10.4065/84.6.509

Cited by 29 publications

(20 citation statements)

References 40 publications

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“…Criteria for operability have evolved in recent years, as it has become evident that surgery in carefully selected patients of advanced age and with impaired lung function may be a safe and feasible treatment option and can be associated with reasonable quality of life outcomes in spite of a higher incidence of postoperative complications. [7][8][9][10][11][12][13][14] To determine whether the patient may tolerate general anesthesia and pulmonary resection, a thorough medical history should be obtained. Patients who have experienced angina pectoris or similar symptoms in the past or those with known underlying cardiovascular disease should be risk stratified by additional functional testing.…”

Section: Considerations Prior To Surgical Resectionmentioning

confidence: 99%

Surgical Management of Lung Cancer

Tomaszek

Wigle

2011

Semin Respir Crit Care Med

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Lung cancer continues to be the most frequent cancer-related cause of death in the United States and throughout the world. Surgical resection is currently the most effective treatment in early-stage non-small-cell lung cancer, and historically the only treatment approach achieving significant cure rates. In advanced disease, therapeutic approaches involving chemotherapy and/or radiation therapy are utilized to improve prognosis, either as part of a neoadjuvant treatment approach followed by surgical resection or as definitive treatment alone. The role of surgery in locally advanced or metastatic non-small-cell lung cancer remains controversial, with more studies required to further refine the application of modern surgical techniques. For any treatment approach, thorough preoperative staging as well as careful patient selection are essential to assess the benefits and risks involved for the patient. Surgical management of early-stage non-small-cell lung cancer and its role in more advanced disease are discussed in this review.

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Section: Considerations Prior To Surgical Resectionmentioning

confidence: 99%

Surgical Management of Lung Cancer

Tomaszek

Wigle

2011

Semin Respir Crit Care Med

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“…VATS lobectomy offers more advantages than thoracotomy lobectomy in terms of short‐term postoperative outcomes, including less postoperative pain, faster postoperative recovery, greater preservation of pulmonary function, and lower perioperative morbidity . Moreover, VATS lobectomy is equivalent to thoracotomy in terms of oncologic outcomes, including survival and recurrence rates …”

Section: Introductionmentioning

confidence: 99%

“…3 Moreover, VATS lobectomy is equivalent to thoracotomy in terms of oncologic outcomes, including survival and recurrence rates. 4,5 Recent studies have suggested that surgical resection following neoadjuvant chemotherapy for patients with locally advanced NSCLC can significantly improve the complete surgical resection (R0) rate and long-term survival. 2,6,7 However, the feasibility and clinical efficacy of performing VATS pulmonary resection after neoadjuvant CRT remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and surgical outcomes of video‐assisted thoracoscopic pulmonary resection in patients with advanced‐stage lung cancer after neoadjuvant chemoradiotherapy

et al. 2019

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Video‐assisted thoracoscopic surgery (VATS) is regarded as the standard treatment for lung cancer. However, the feasibility and safety of VATS for lung cancer after neoadjuvant chemoradiotherapy (CRT) is unclear. This study evaluated the feasibility and safety of VATS in patients who had received neoadjuvant CRT. Methods Between January 2008 and December 2017, 85 patients who were administered neoadjuvant CRT and underwent anatomic lung resection were enrolled. Fifty‐nine patients underwent open thoracotomy and 26 patients underwent VATS. The clinical characteristics and perioperative outcomes were reviewed. Results In six of the initial 32 patients who underwent VATS, the procedure was converted to thoracotomy. Adjacent structural invasion (33.9% vs. 11.5%; P = 0.037) and combined resection (16.9% vs. 0%; P = 0.025) were higher in the open group than in the VATS group. Surgical duration was higher in the open group than in the VATS group (203.86 ± 65.97 vs. 173.27 ± 59.87 minutes; P = 0.046). With regard to postoperative outcomes, the length of the hospital stay was longer in the open group compared to the VATS group (14.46 ± 16.94 vs. 8.62 ± 4.72 days; P = 0.017). There was no significant difference in the three‐year disease‐free survival (69.3% vs. 67.9%; P = 0.879) or overall survival rates (76.6% vs. 61.9%; P = 0.516). Conclusion In selected patients, VATS pulmonary resection after neoadjuvant CRT showed results comparable to that of thoracotomy in terms of postoperative outcomes, operative morbidities, and survival rate.

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“…VATS lobectomy is thought to have more advantages than lobectomy under thoracotomy in postoperative pain [4], postoperative recovery [5], preservation of pulmonary function [6], immune surveillance [7], and surgical complications [8]. In addition, oncologic studies have showed VATS lobectomy is equivalent to thoracotomy in overall survival and recurrence rate [9,10].…”

mentioning

confidence: 99%