Total videothoracoscopic lobectomy versus open thoracotomy for early-stage non small-cell lung cancer.

Abstract:

:Lobectomy remains the standard procedure for early-stage non small-cell lung cancer (NSCLC). Advances in minimally invasive surgery allow lobectomy to be performed by videothoracoscopy (VATSLOBE). The objective of this study was to compare open thoracotomy (OPENLOBE) to VATSLOBE in the treatment of early-stage NSCLC. A retrospective review over a 6-year period at a single tertiary care center identified 31 patients treated by VATSLOBE. A comparison was made with 31 patients undergoing OPENLOBE during the same time period. The cases were matched for age, pulmonary function testing, tumor size, and comorbidities. The VATSLOBE technique was carried out using four 1 cm thoracoports, one of which was enlarged to a 4-6 cm access incision for lobe retrieval. OPENLOBE was performed by standard posterolateral thoracotomy. The VATSLOBE group had a longer operative time (214.03 min) compared to OPENLOBE (140.67 min). There was no difference in the extent of lymph node dissection or in morbidity between the two groups. VATSLOBE patients had their chest tubes removed earlier (4.77 vs. 8.16 days) and stayed in the hospital for a shorter time (7.07 vs. 11.94 days) compared to OPENLOBE patients. In this retrospective review, lobectomy performed by the videothoracoscopic approach was comparable to OPENLOBE in terms of lymph node dissection, morbidity, and long-term survival. VATSLOBE had the advantages of a shorter hospital stay and fewer days with a chest tube. Minimally invasive surgery for early-stage lung cancer should be further investigated in multi-institutional controlled trials.

journal_name

Clin Lung Cancer

journal_title

Clinical lung cancer

authors

Luketich JD,Meehan MA,Landreneau RJ,Christie NA,Close JM,Ferson PF,Keenan RJ,Belani CP

doi

10.3816/clc.2000.n.018

keywords:

subject

Has Abstract

pub_date

2000-08-01 00:00:00

pages

56-60; discussion 61

issue

1

eissn

1525-7304

issn

1938-0690

pii

S1525-7304(11)70623-4

journal_volume

2

pub_type

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