Hybrid treatment of T3 chest wall lung cancer lobectomy

Abstract

Nowadays the treatment of patients with non-small cell lung cancer (NSCLC) that invades the chest wall is still questioned. The classic approach is a lobectomy that requires chest wall resection through thoracotomy, but thanks to the progress in the field of thoracoscopic surgery, this procedure can be performed by video-assisted thoracoscopic surgery (VATS). Major advances have been made in recent years both in the surgical technique associated with thoracoscopy and in the instrumentation available today. This has allowed the use of thoracoscopic technique even in advanced disease. To choose to perform complex surgery in assisted video surgery, considerable experience is needed to avoid making mistakes and giving up a better approach for the patient only for any technical difficulties. Thoracoscopy is not currently the preferred intervention for patients with chest wall invasion because there are insufficient studies on the feasibility of lobectomy with thoracoscopic wall resection, although the thoracoscopic approach has reduced mortality and morbidity in lung cancer cases not in advanced stage. We discuss our experience in three patients using hybrid approach with assisted video thoracoscopic lobectomy and a chest wall resection with an alternative method of estimating thoracic wall resection that uses assisted video surgery and hypodermic needles (minimally invasive posterior approach).

Single-port video-assisted thoracic surgery (VATS)—advanced procedures & update

“…Then they did an en bloc resection of the chest wall with three ribs with a second posterior incision without rib spreading. The authors reported a good postoperative outcome without major mortality (30).…”

Hybrid video-assisted thoracoscopic surgery sleeve lobectomy for non-small cell lung cancer: a case report

“…Current literature shows that the hybrid VATS approach has advantages for selected NSCLC patients over conventional open surgery (13,14). Dr.…”

“…Also, hybrid VATS SL is a safer approach, especially in patients with infiltration of the pulmonary artery (PA), as it makes the surgeon more comfortable during the bronchial and arterial anastomoses. Literatures have shown that hybrid VATS approach has advantages for select T3 chest wall lung cancers (13) and superior sulcus tumors (14) over conventional open surgery. Dr.…”