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Erschienen in: World Journal of Surgery 9/2009

01.09.2009

Video-Assisted Thoracic Surgery (VATS) Compares Favorably with Thoracotomy for the Treatment of Lung Cancer: A Five-Year Outcome Comparison

verfasst von: Xueying Yang, Shumin Wang, Jiaqi Qu

Erschienen in: World Journal of Surgery | Ausgabe 9/2009

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Abstract

Background

Although video-assisted thoracic surgery (VATS) lobectomy has been demonstrated to be safe and technically feasible, it is infrequently performed in most Chinese hospitals and few thoracic surgeons have performed the operation. We have therefore reviewed our experience with all VATS lobectomies, attempting to define long- and short-term outcomes of these surgeries.

Methods

We retrospectively analyzed the results in patients who underwent VATS lobectomy and open lobectomy between March 1996 and August 2003. The VATS surgery was performed with the endoscopic hilar dissection technique. Perioperative data were collected and long-term outcomes were assessed by 5-year census.

Results

We successfully performed VATS procedures in 113 of 120 patients. The median operative time was 152 min and the median hospitalization was 8.6 days. The median operative blood loss was 130 ml and the median drainage time was 3.5 days. The operative and perioperative (30-day) mortality rates were 0% and 0.9%, respectively; the postoperative complications rate was 10.6%. The 5-year overall survival rates for stage I, stage II, and stage III or greater non-small cell lung cancer (NSCLC), secondary pulmonary malignancy, and benign disease were 79.1%, 45.5%, 22.2%, 33.3%, and 88.6%, respectively.

Conclusions

Video-assisted lobectomy is a safe and feasible surgical procedure, and it gives the same long-term results as conventional open lobectomy. The VATS approach to lobectomy is a beneficial alternative to standard thoracotomy for selected cases of pulmonary lesions.
Literatur
1.
Zurück zum Zitat Hazelrigg SR, Landreneau RJ, Boley TM et al (1991) The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain. J Thorac Cardiovasc Surg 101:394–401PubMed Hazelrigg SR, Landreneau RJ, Boley TM et al (1991) The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain. J Thorac Cardiovasc Surg 101:394–401PubMed
2.
Zurück zum Zitat Sugi K, Kaneda Y, Esato K (2000) Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg 24:27–30PubMedCrossRef Sugi K, Kaneda Y, Esato K (2000) Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg 24:27–30PubMedCrossRef
3.
Zurück zum Zitat McKenna RJ, Houck W, Fuller CB (2006) Video-assisted thoracic surgery lobectomy: experience with 1100 cases. Ann Thorac Surg 81:421–426PubMedCrossRef McKenna RJ, Houck W, Fuller CB (2006) Video-assisted thoracic surgery lobectomy: experience with 1100 cases. Ann Thorac Surg 81:421–426PubMedCrossRef
4.
Zurück zum Zitat Li WW, Lee RL, Lee TW et al (2003) The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy. Eur J Cardiothorac Surg 23:390–396PubMedCrossRef Li WW, Lee RL, Lee TW et al (2003) The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy. Eur J Cardiothorac Surg 23:390–396PubMedCrossRef
5.
Zurück zum Zitat Yim APC, Ko K, Ma C et al (1996) Thoracoscopic lobectomy for benign diseases. Chest 109:554–556PubMedCrossRef Yim APC, Ko K, Ma C et al (1996) Thoracoscopic lobectomy for benign diseases. Chest 109:554–556PubMedCrossRef
6.
Zurück zum Zitat Tsang FH, Chung SS, Sihoe AD (2006) Video-assisted thoracic surgery for bronchopulmonary sequestration. Interact Cardiovasc Thorac Surg 5:424–426PubMedCrossRef Tsang FH, Chung SS, Sihoe AD (2006) Video-assisted thoracic surgery for bronchopulmonary sequestration. Interact Cardiovasc Thorac Surg 5:424–426PubMedCrossRef
7.
Zurück zum Zitat Shiraishi T, Shirakusa T, Miyoshi T et al (2006) A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer—technique, feasibility, and advantages. Thorac Cardiovasc Surg 54:202–207PubMedCrossRef Shiraishi T, Shirakusa T, Miyoshi T et al (2006) A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer—technique, feasibility, and advantages. Thorac Cardiovasc Surg 54:202–207PubMedCrossRef
8.
Zurück zum Zitat Oda M, Ishikawa N, Tsunezuka Y et al (2007) Closed three-port anatomic lobectomy with systematic nodal dissection for lung cancer. Surg Endosc 21:1464–1465PubMedCrossRef Oda M, Ishikawa N, Tsunezuka Y et al (2007) Closed three-port anatomic lobectomy with systematic nodal dissection for lung cancer. Surg Endosc 21:1464–1465PubMedCrossRef
9.
Zurück zum Zitat Tajiri M, Maehara T, Nakayama H et al (2007) Decreased invasiveness via two methods of thoracoscopic lobectomy for lung cancer, compared with open thoracotomy. Respirology 12:207–211PubMedCrossRef Tajiri M, Maehara T, Nakayama H et al (2007) Decreased invasiveness via two methods of thoracoscopic lobectomy for lung cancer, compared with open thoracotomy. Respirology 12:207–211PubMedCrossRef
10.
Zurück zum Zitat McKenna RJ Jr, Houck WV (2005) New approaches to the minimally invasive treatment of lung cancer. Curr Opin Pulm Med 11:282–286PubMedCrossRef McKenna RJ Jr, Houck WV (2005) New approaches to the minimally invasive treatment of lung cancer. Curr Opin Pulm Med 11:282–286PubMedCrossRef
11.
Zurück zum Zitat Shiraishi T, Shirakusa T, Miyoshi T et al (2006) A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer—technique, feasibility, and advantages. Thorac Cardiovasc Surg 54:202–207PubMedCrossRef Shiraishi T, Shirakusa T, Miyoshi T et al (2006) A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer—technique, feasibility, and advantages. Thorac Cardiovasc Surg 54:202–207PubMedCrossRef
12.
Zurück zum Zitat Roviaro G, Rebuffat C, Varoli F et al (1992) Videoendoscopic pulmonary lobectomy for cancer. Surg Laparosc Endosc 2:244–247PubMed Roviaro G, Rebuffat C, Varoli F et al (1992) Videoendoscopic pulmonary lobectomy for cancer. Surg Laparosc Endosc 2:244–247PubMed
13.
Zurück zum Zitat Lewis RJ, Sisler GE, Caccavale RJ (1992) Imaged thoracic lobectomy: should it be done? Ann Thorac Surg 54:80–83PubMedCrossRef Lewis RJ, Sisler GE, Caccavale RJ (1992) Imaged thoracic lobectomy: should it be done? Ann Thorac Surg 54:80–83PubMedCrossRef
14.
Zurück zum Zitat Kirby TJ, Rice TW (1993) Thoracoscopic lobectomy. Ann Thorac Surg 56:784–786PubMed Kirby TJ, Rice TW (1993) Thoracoscopic lobectomy. Ann Thorac Surg 56:784–786PubMed
15.
Zurück zum Zitat Haraguchi S, Koizumi K, Hatori N et al (2004) Postoperative respiratory complications of video-assisted thoracic surgery for lung cancer. J Nippon Med Sch 71:30–34PubMedCrossRef Haraguchi S, Koizumi K, Hatori N et al (2004) Postoperative respiratory complications of video-assisted thoracic surgery for lung cancer. J Nippon Med Sch 71:30–34PubMedCrossRef
16.
Zurück zum Zitat Sedrakyan A, van der Meulen J, Lewsey J et al (2004) Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials. BMJ 329(7473):1008PubMedCrossRef Sedrakyan A, van der Meulen J, Lewsey J et al (2004) Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials. BMJ 329(7473):1008PubMedCrossRef
17.
Zurück zum Zitat Mahtabifard A, DeArmond DT, Fuller CB et al (2007) Video-assisted thoracoscopic surgery lobectomy for stage I lung cancer. Thorac Surg Clin 17:223–231PubMedCrossRef Mahtabifard A, DeArmond DT, Fuller CB et al (2007) Video-assisted thoracoscopic surgery lobectomy for stage I lung cancer. Thorac Surg Clin 17:223–231PubMedCrossRef
18.
Zurück zum Zitat Shigemura N, Yim AP (2007) Variation in the approach to VATS lobectomy: effect on the evaluation of surgical morbidity following VATS lobectomy for the treatment of stage I non-small cell lung cancer. Thorac Surg Clin 17:233–239PubMedCrossRef Shigemura N, Yim AP (2007) Variation in the approach to VATS lobectomy: effect on the evaluation of surgical morbidity following VATS lobectomy for the treatment of stage I non-small cell lung cancer. Thorac Surg Clin 17:233–239PubMedCrossRef
19.
Zurück zum Zitat Yim AP, Wan S, Lee TW et al (2000) VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 70:243–247PubMedCrossRef Yim AP, Wan S, Lee TW et al (2000) VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg 70:243–247PubMedCrossRef
20.
Zurück zum Zitat Nagahiro I, Andou A, Aoe M et al (2001) Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg 72:362–365PubMedCrossRef Nagahiro I, Andou A, Aoe M et al (2001) Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg 72:362–365PubMedCrossRef
21.
Zurück zum Zitat Sugi K, Kaneda Y, Esato K (2000) Video-assisted thoracoscopic lobectomy reduces cytokine production more than conventional open lobectomy. Jpn J Thorac Cardiovasc Surg 48:161–165PubMedCrossRef Sugi K, Kaneda Y, Esato K (2000) Video-assisted thoracoscopic lobectomy reduces cytokine production more than conventional open lobectomy. Jpn J Thorac Cardiovasc Surg 48:161–165PubMedCrossRef
22.
Zurück zum Zitat West D, Rashid S, Dunning J (2007) Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobectomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg 6:110–116PubMedCrossRef West D, Rashid S, Dunning J (2007) Does video-assisted thoracoscopic lobectomy produce equal cancer clearance compared to open lobectomy for non-small cell carcinoma of the lung? Interact Cardiovasc Thorac Surg 6:110–116PubMedCrossRef
23.
Zurück zum Zitat Petersen RP, Pham D, Toloza EM et al (2006) Thoracoscopic lobectomy: a safe and effective strategy for patients receiving induction therapy for non-small cell lung cancer. Ann Thorac Surg 82:214–218PubMedCrossRef Petersen RP, Pham D, Toloza EM et al (2006) Thoracoscopic lobectomy: a safe and effective strategy for patients receiving induction therapy for non-small cell lung cancer. Ann Thorac Surg 82:214–218PubMedCrossRef
24.
Zurück zum Zitat Shaw JP, Dembitzer FR, Wisnivesky JP et al (2008) Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac 85:S705–S709CrossRef Shaw JP, Dembitzer FR, Wisnivesky JP et al (2008) Video-assisted thoracoscopic lobectomy: state of the art and future directions. Ann Thorac 85:S705–S709CrossRef
25.
Zurück zum Zitat Solaini L, Prusciano F, Bagioni P et al (2001) Video-assisted thoracic surgery major pulmonary resections. Present experience. Eur J Cardiothorac Surg 20:437–442CrossRef Solaini L, Prusciano F, Bagioni P et al (2001) Video-assisted thoracic surgery major pulmonary resections. Present experience. Eur J Cardiothorac Surg 20:437–442CrossRef
Metadaten
Titel
Video-Assisted Thoracic Surgery (VATS) Compares Favorably with Thoracotomy for the Treatment of Lung Cancer: A Five-Year Outcome Comparison
verfasst von
Xueying Yang
Shumin Wang
Jiaqi Qu
Publikationsdatum
01.09.2009
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 9/2009
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-009-0137-9

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