The role of thoracoscopic pneumonectomy in the management of non–small cell lung cancer: A multicenter study

Yang, Chi‐Fu Jeffrey; Yendamuri, Sai; Mayne, Nicholas R.; Battoo, Athar; Wang, Hanghang; Meyerhoff, Robert; VanDusen, Keith W.; Hirji, Sameer; Berry, Mark F.; McKenna, Robert J.; Demmy, Todd L.; D’Amico, Thomas A.

doi:10.1016/j.jtcvs.2018.12.001

Cited by 26 publications

(18 citation statements)

References 17 publications

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“…The only multi-center review conducted by Yang et al included 124 VATS pneumonectomy to 235 open operations. Outcomes mirrored prior studies with a 19% conversion rate, and persistent differences are found only on the extent of lymph node dissection leaning in favor of the VATS approach ( 40 ) ( Table 5 ). Data on robotic resections are sparse.…”

Section: Robotic Pneumonectomysupporting

confidence: 63%

Extended Robotic Pulmonary Resections

et al. 2021

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While lung cancer remains the most common cause of cancer-related mortality in the United States, surgery for curative intent continues to be a mainstay of therapy. The robotic platform for pulmonary resection for non-small cell lung cancer (NSCLC) has been utilized for more than a decade now. With respect to more localized resections, such as wedge resection or lobectomy, considerable data exist demonstrating shorter length of stay, decreased postoperative pain, improved lymph node dissection, and overall lower complication rate. There are a multitude of technical advantages the robotic approach offers, such as improved optics, natural movement of the operator's hands to control the instruments, and precise identification of tissue planes leading to a more ergonomic and safe dissection. Due to the advantages, the scope of robotic resections is expanding. In this review, we will look at the existing data on extended robotic pulmonary resections, specifically post-induction therapy resection, sleeve lobectomy, and pneumonectomy. Additionally, this review will examine the indications for these more complex resections, as well as review the data and outcomes from other institutions' experience with performing them. Lastly, we will share the strategy and outlook of our own institution with respect to these three types of extended pulmonary resections. Though some controversy remains regarding the use and safety of robotic surgery in these complex pulmonary resections, we hope to shed some light on the existing evidence and evaluate the efficacy and safety for patients with NSCLC.

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Section: Robotic Pneumonectomysupporting

confidence: 63%

Extended Robotic Pulmonary Resections

et al. 2021

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“…70 A more recent multi-institutional study demonstrated shorter chest tube duration as well as greater lymph node yield in patients who had VATS pneumonectomy compared with thoracotomy, with noninferior oncologic outcomes. 71 Understandably, the rate of conversion (19% overall) was higher compared with most VATS lobectomy series; however, the conversion rate also decreased with time, and with increased surgeon experience. Complication rates are similar between the groups, suggesting that VATS pneumonectomy may prove to be noninferior to the open approach.…”

Section: Cost Of Vats Lobectomymentioning

confidence: 90%

VATS and Minimally Invasive Resection in Early-Stage NSCLC

Salfity

Tong

2020

Semin Respir Crit Care Med

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Lung carcinoma widely affects men and women in the sixth and seventh decades of life. Thorough workup with radiographic imaging, pathologic diagnosis, and cardiopulmonary functional assessment is key to successful treatment. Accurate staging is essential for both assessing prognosis and directing therapy. Early-stage lung cancer is most often treated with anatomic lobectomy; locally advanced cancers may require induction or adjuvant therapies. Any nonnodal metastases will require definitive systemic therapy. Traditionally, surgery was performed with a posterolateral thoracotomy incision, division of the hilar vessels, removal of affected lung parenchyma, and a complete mediastinal and hilar lymph node dissection for accurate pathologic staging. In recent years, however, video-assisted thoracoscopic (VATS) or other minimally invasive approaches have emerged as the standard of care for early-stage disease. Compared with standard thoracotomy, VATS lobectomy offers improved postoperative outcomes as well as potential survival benefit. Thoracoscopic lobectomy is also cost-effective. This article focuses on the technique, outcomes, adaptation, and evolution of thoracoscopic lobectomy and other minimally invasive techniques in the treatment of lung cancer.

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“…It is also challenging for surgeons due to centrally located, large tumors invading hilar vessels, obstructive inflammation, and with a higher risk of bleeding. There have been some previously reported studies on series of multiportal VATS pneumonectomies 14–16 . However, according to our knowledge, the reports on uniportal VATS pneumonectomies have not gone beyond case reports or video presentations 4,5,17 .…”

Section: Introductionmentioning

confidence: 97%

Uniportal video‐assisted thoracoscopic left pneumonectomy: Retrospective analysis of eighteen consecutive patients from a single center

Xue

Gao

et al. 2021

Thoracic Cancer

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Background Uniportal video‐assisted thoracoscopic surgery (VATS) is being more widely used in lung cancer, yet reports on its application in pneumonectomies are limited. This study aimed to evaluate the safety and feasibility of uniportal video‐assisted thoracoscopic left pneumonectomy for lung cancer. Methods A series of 18 lung cancer patients who had received uniportal video‐assisted thoracoscopic left pneumonectomies were included in the study. Their clinical, pathological, and surgical features, as well as postoperative recovery, were analyzed. Results The majority of the patients were male and smokers and their average age was 62.0 ± 8.9 years. All had primary lung cancer, while three (16.7%) had received neoadjuvant therapy. A total of 16 (88.9%) patients had stage II–III disease, with an average tumor size of 3.6 ± 1.5 cm. The average surgery time was 137.4 ± 47.0 minutes, with a 16.7% (3/18) conversion rate. The mean blood loss was 37.5 ± 59.4 mL and no patients needed blood transfusion during, or after, surgery. There was no perioperative death and the overall complication rate was 22.2% (4/18). Two (11.1%) patients needed to stay in the intensive care unit after surgery, and the average length of hospital stay after surgery was 6.3 ± 1.1 days (range 4–7 days). Conclusions Uniportal video‐assisted thoracoscopic left pneumonectomy is a safe and feasible procedure for selected lung cancer patients. The use of uniportal VATS in right pneumonectomies and the effect of uniportal video‐assisted thoracoscopic pneumonectomy on the survival of patients merits further study. Patients receiving uniportal VATS pneumonectomies had standard surgical results and recovery. Uniportal VATS pneumonectomy is safe for properly selected lung cancer patients. Key points Significant findings of the study: • Patients receiving uniportal VATS left pneumonectomies had standard surgical results and recovery. What this study adds: • Uniportal VATS left pneumonectomy is safe for properly selected lung cancer patients.

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The role of thoracoscopic pneumonectomy in the management of non–small cell lung cancer: A multicenter study

Cited by 26 publications

References 17 publications

Extended Robotic Pulmonary Resections

Extended Robotic Pulmonary Resections

VATS and Minimally Invasive Resection in Early-Stage NSCLC

Uniportal video‐assisted thoracoscopic left pneumonectomy: Retrospective analysis of eighteen consecutive patients from a single center

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