Video-assisted thoracoscopic lobectomy for lung cancer

Hyun Koo Kim

doi:10.5124/jkma.2012.55.12.1193

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Kim: Video-assisted thoracoscopic lobectomy for lung cancer

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2012; 55(12): 1193-1198.

Published online: 18 December 2012

DOI: https://doi.org/10.5124/jkma.2012.55.12.1193

Video-assisted thoracoscopic lobectomy for lung cancer

Hyun Koo Kim, MD

Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Corresponding author: Hyun Koo Kim, kimhyunkoo@korea.ac.kr

Received 16 October 2012 Accepted 30 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Video-assisted thoracoscopic surgery (VATS) provides a new approach for treating early-stage lung cancer. VATS lobectomy has significant perioperative advantages such having as a lower rate of morbidity and being less immunosuppressive than open lobectomy, and it also provides a shorter recovery time, less postoperative pain, and faster resumption of a normal lifestyle. However, a clear definition of VATS lobectomy is lacking in the current literature. The generally accepted method of VATS lobectomy is from three to four incisions in number of port, 4.0 to 8.0 cm in utility length, and without rib spreading. However, there is still much debate on the role of VATS in lobectomy for the treatment of lung cancer. Concerns regarding safety, the extent of mediastinal lymph node dissection, and long-term survival have made some surgeons apprehensive of its validity for lung cancer. Nevertheless, recent data have shown that VATS lobectomy appears to have equivalent oncological results compared with open lobectomy for patients with early stage non-small cell lung cancer. With growing experience with VATS and development of thoracoscopic instrument, VATS can be beneficial to patients with early stage of lung cancer.

Keywords: Video-assisted thoracoscopic surgery, Lobectomy, Lung neoplasms

Figures and Tables

Figure 1

Utility incision and ports placement for video-assisted thoracoscopic surgery right lower lobecotmy.

Figure 2

(A) Right inferior pulmonary vein dissection. (B) Division using endostapler.

Figure 3

(A) Dissection of pulmonary artery to lower lobe. (B) Division using endostapler.

Figure 4

(A) Dissection of right lower lobe bronchus. (B) Division using endostapler.

Figure 5

(A) Dissection of subcarinal lymph node. (B) Dissection of right paratracheal lymph node. SVC, superior vena cava.

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