Video-assisted vs open mediastinal lymphadenectomy for Stage I non-small-cell lung cancer: results of a prospective randomized trial†

Palade, Emanuel; Passlick, Bernward; Osei-Agyemang, T; Günter, Jutta; Wiesemann, Sebastian

doi:10.1093/ejcts/ezs668

Cited by 65 publications

(48 citation statements)

References 13 publications

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“…3,4,6) In a multicenter study, D'Amico et al 5) compared 199 patients undergoing VATS with 189 patients undergoing T, and found similar results. Unlike the previous studies concerning of patients with N0 diseases, the latter one included also patients with N2 and N3 diseases.…”

Section: Discussionmentioning

confidence: 90%

“…In 2013, Palade et al 6) published their study compairing VATS and open mediastinal lymphadenectomy. They classified N1 and N2-level lymph nodes into different zones, and made a detailed comparison between two approaches.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors compared thoracotomy to VATS in the dissection of N1 and N2-level lymph nodes. [3][4][5][6][7][8][9][10] Besides, there are some reports comparing thoracotomy and RATS, and VATS and RATS. [11][12][13][14] Based on these studies, the results are controversial about the superiority of a "specific" surgical technique.…”

Section: Introductionmentioning

confidence: 99%

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Lymph Node Dissection in Surgery for Lung Cancer: Comparison of Open vs. Video-Assisted vs. Robotic-Assisted Approaches

Toker

Özyurtkan

Demirhan

et al. 2016

ATCS

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Lymph Node Dissection in Surgery for Lung Cancer: Comparison of Open vs. Video-Assisted vs. Robotic-Assisted Approaches

Toker

Özyurtkan

Demirhan

et al. 2016

ATCS

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“…Palade et al had carried out a prospective randomized controlled study on the effectiveness of MLN dissection under VATS (17). The results indicated that operation time was distinctly shorter in VATS group, with the The results revealed that the average MLN numbers and group numbers were 22.5 and 5.0, respectively, and no one was converted into thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

Retrospective study on video-assisted vs. open mediastinal lymphadenectomy for non-small cell lung cancer: a propensity-matched analysis

Shen

et al. 2018

J. Thorac. Dis.

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Background: This retrospective study is designed to compare the surgical outcomes of mediastinal lymph node (MLN) dissection between the two groups of non-small cell lung cancer (NSCLC) patients underwent lung cancer surgery through video-assisted thoracoscopic surgery (VATS) or thoracotomy, as well as classify the differences and identify the safer method between two groups.Methods: A total of 497 patients underwent pulmonary lobectomy and systemic MLN dissection were enrolled in this study. They were divided into VATS group (n=242) and traditional thoracotomy (TT) group (n=255). The VATS group received three-port VATS, while the thoracotomy group underwent posteriorlateral or muscle sparing thoracotomy. The range of MLN dissection included groups 2R, 4R, 7, 8, 9 in right-sided lung cancer surgery and groups 4L, 5, 6, 7, 8, 9 in left-sided. The two groups were matched at a ratio of 1:1 using the propensity score matching (PSM) method.Results: Out of 497 patients, 376 cases were matched for PSM, with 188 cases in each group. Baseline date did not get any significant difference between two groups. The average group number of MLN dissection in VATS group and TT group was 4.14 and 3.97, respectively. While the average amount of dissected lymph nodes in both groups were 16.63 and 17.32, respectively. Compare with the lymph node numbers among all the groups in TT group, only the number of group 7 though left approach (7L) in VATS group was statically significant. Besides, the operation time and postoperative length of hospital stay in VATS group were superior to those in TT group (P<0.05). No significant difference had been found in intraoperative blood loss, accessory surgical injury and postoperative complication between two groups. Conclusion:Compared with thoracotomy, systemic MLN dissection and pulmonary lobectomy via VATS has quicker recovery, less postoperative complication and length of hospital stay with similar surgical outcomes. Moreover, our findings also suggest thoracotomy has an advantage on the dissection of MLN in group 7L. IntroductionSince the first case of performing anatomical lobectomy and systemic mediastinal lymph node (MLN) dissection under video-assisted thoracoscopic surgery (VATS) was reported in 1990s, treating VATS procedure has been rapidly popularized for its minor surgical trauma, rapid postoperative recovery, short length of stay, good patient tolerance and so on (1-5). More importantly, its surgical safety and effectiveness have been extensively verified. The National Comprehensive Cancer Network (NCCN) has suggested in its non-small cell lung cancer (NSCLC) Treatment Guideline in 2012 that, VATS can be used as a standard procedure for treating early NSCLC (6).During the past decade has witnessed the rapid development of VATS technology, thanks to the innovations of surgical technique and sophisticated instruments. The surgical method has developed from the traditional tri-and quadric-port VATS to single intercostal or even uniport approach. In addition, the surgical method has st...

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“…Some controversies still exist with regard to the quality of minimally invasive sLND. While the number of dissected lymph nodes (LN) in VATS procedures is equal to the open approach, the nodal upstaging rate from clinical to pathological N-factor has been reported to be lower after a VATS approach [7][8][9].…”

mentioning

confidence: 99%

A standardized technique of systematic mediastinal lymph node dissection by video-assisted thoracoscopic surgery (VATS) leads to a high rate of nodal upstaging in early-stage non-small cell lung cancer

et al. 2015

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Video-assisted vs open mediastinal lymphadenectomy for Stage I non-small-cell lung cancer: results of a prospective randomized trial†

Abstract: Mediastinal lymph node dissection can be performed as effectively by the video-assisted approach as by the open thoracotomy approach. Furthermore, the video-assisted approach allows a better visualization of different lymph node zones.

Cited by 65 publications

References 13 publications

Lymph Node Dissection in Surgery for Lung Cancer: Comparison of Open vs. Video-Assisted vs. Robotic-Assisted Approaches

Lymph Node Dissection in Surgery for Lung Cancer: Comparison of Open vs. Video-Assisted vs. Robotic-Assisted Approaches

Retrospective study on video-assisted vs. open mediastinal lymphadenectomy for non-small cell lung cancer: a propensity-matched analysis

A standardized technique of systematic mediastinal lymph node dissection by video-assisted thoracoscopic surgery (VATS) leads to a high rate of nodal upstaging in early-stage non-small cell lung cancer

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