Video-Assisted Thoracoscopic Surgery vs Thoracotomy for Non-Small Cell Lung Cancer Greater Than 5 cm: Is VATS a feasible approach for large tumors?

Batıhan, Güntuğ; Ceylan, Kenan Can; Usluer, Ozan; Kaya, Şeyda Örs

doi:10.1186/s13019-020-01305-w

Cited by 19 publications

(21 citation statements)

References 19 publications

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“…A retrospective study of stage IA NSCLC patients who underwent lobectomy demonstrated that VATS was associated with increased 5-year OS compared to open thoracotomy (100% vs. 87%, p = 0.01) and DFS (100% vs. 86%, p = 0.03) ( 63 ). In tumors greater than 5 cm, VATS was associated with greater OS and DFS ( p = 0.056 and 0.031, respectively) compared to open thoracotomy ( 64 ), and in clinical N2 lung cancer, VATS showed similar 5-year OS (50.5% vs. 48.4%, p = 0.127) and DFS (60.5% vs. 44.6%, p = 0.069) ( 65 ). A study of oncological outcomes in patients who underwent surgical resection for early-stage lung cancer found no differences in 5-year OS (71.6% vs. 65.9%, p = 0.36) and DFS (75.2% vs. 69.2%, p = 0.55) between VATS and open lobectomy ( 66 ).…”

Section: Perioperative Modulation Of Inflammatory Response and Oncolo...mentioning

confidence: 99%

Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Choi

Hwang

2022

Front. Surg.

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While surgical resection is the gold standard treatment for solid tumors, cancer recurrence after surgery is common. Immunosurveillance of remnant tumor cells is an important protective mechanism. Therefore, maintenance of anti-tumor cell activity and proper levels of inflammatory mediators is crucial. An increasing body of evidence suggests that surgery itself and perioperative interventions could affect these pathophysiological responses. Various factors, such as the extent of tissue injury, perioperative medications such as anesthetics and analgesics, and perioperative management including transfusions and methods of mechanical ventilation, modulate the inflammatory response in lung cancer surgery. This narrative review summarizes the pathophysiological mechanisms involved in cancer recurrence after surgery and perioperative management related to cancer recurrence after lung cancer surgery.

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Section: Perioperative Modulation Of Inflammatory Response and Oncolo...mentioning

confidence: 99%

Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Choi

Hwang

2022

Front. Surg.

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“…Non-intubated thoracic surgical procedures are widely used to perform minor and major thoracic surgeries, and is a feasible technique to perform pleural and lung biopsies, metastasectomies, anatomical lung resections and surgeries to pneumothorax (66,67). The main principle is to create iatrogenic pneumothorax, thus, the operator has enough space to implement the surgery and to avoid the use of double-lumen endotracheal tube.…”

Section: The Immune and Oncological Effects Of Nonintubated Thoracic ...mentioning

confidence: 99%

Immunological perspectives in thoracic surgery: a narrative review on the cellular and cytokine responses induced by thoracotomy and video-assisted thoracic surgery

Paróczai¹,

Lantos²,

Barta³

et al. 2022

AME Surg J

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Objective: To reveal and review the main effects of mechanical ventilation, anaesthesia, thoracotomy and thoracoscopy on immune responses and clinical outcomes.Background: Several trials reported that intubated video-assisted thoracic surgery (VATS) is associated with favourable recovery time, hospital stay, fewer postoperative complications, better delivery and tolerability of adjuvant chemotherapy in patients with non-small cell lung cancer (NSCLC) as compared to traditional thoracotomy. Recent studies introduced a new approach in thoracic surgery focusing on the immunological outcomes and detrimental effects of thoracotomy and VATS along with patients' clinical benefits.Methods: We reviewed main laboratory and human research based on PubMed database to reveal the immune effects of intubated and non-intubated VATS, mechanical one-lung ventilation (mOLV) and anaesthesia on inflammatory cytokine production, cell responses and clinical outcomes.Conclusions: Although, there are still inconsistencies regarding whether VATS can improve long-term survival and immune responses. VATS results in better preserved immune functions: the postoperative number of natural killer (NK) cells, lymphocytes were less suppressed and the release of immunomodulatory interleukin (IL)-6 and IL-10 were reduced, compared to thoracotomy. Both thoracotomy and VATS are known to induce immune responses, however, these effects can be observed to a different extent as it depends on the modes of surgical technique, mOLV and even general anaesthesia. Thus, non-intubated thoracic surgery (NITS) was developed to avoid harmful immune effects, prevent acute lung injury (ALI) and increase patients' long-term survival. NITS could be also associated with less prominent pro-inflammatory cytokine responses and a preserved lymphocyte cell count postoperatively.

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“…In a study, we conducted in our clinic, which included 60 patients with tumors larger than 5 cm, mean drainage time and postoperative length of hospital stay were significantly shorter [50] (Figure 6).…”

Section: The Role Of Vats In the Surgical Treatment Of The Lung Cancermentioning

confidence: 99%

“…Moreover, many studies have demonstrated that VATS can be applied with low complication rates after neoadjuvant therapy or in cases with large tumors [49][50][51][52].…”

Section: Contraindications For Vats Anatomic Lung Resectionmentioning

confidence: 99%

The Role of Minimally Invasive Surgery in the Treatment of Lung Cancer

Batıhan¹,

Ceylan²

2021

Lung Cancer - Modern Multidisciplinary Management

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Lobectomy plus regional lymph node dissection remains the gold standard treatment method in early-stage lung cancer. However, with the demonstration of the safety and efficacy of minimally invasive approaches, the expression of surgery in this statement, replaced by thoracoscopic anatomical lung resection. Clinical studies have demonstrated the superiority of VATS in terms of postoperative pain, drainage time, length of hospital stay, and complications, moreover, long-term oncologic results are similar or better than thoracotomy. Therefore, VATS lobectomy is the preferred surgical method in early-stage lung cancer. Different surgical techniques are available in VATS and can be modified according to the surgeon’s personal experience. Uniport can be applied as well as two or three port incisions. In this book section, I plan to focus on VATS lobectomy, technique-related tricks, complication management, and long-term oncologic results in early and locally advanced lung cancer.

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Video-Assisted Thoracoscopic Surgery vs Thoracotomy for Non-Small Cell Lung Cancer Greater Than 5 cm: Is VATS a feasible approach for large tumors?

Cited by 19 publications

References 19 publications

Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Immunological perspectives in thoracic surgery: a narrative review on the cellular and cytokine responses induced by thoracotomy and video-assisted thoracic surgery

The Role of Minimally Invasive Surgery in the Treatment of Lung Cancer

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