Complete videothoracoscopic en-bloc resection of lung cancer invading the diaphragm

Abstract

Locally advanced non-small cell lung cancer invading the diaphragm is an infrequent clinical presentation. A 74-year-old male patient was operated using video-assisted thoracoscopic surgery in our clinic for a tumor originating from the right lower lobe. A right lower lobectomy with diaphragmatic resection was performed to the tumor with a diameter of 3 cm that invaded the diaphragm, and the resulting defect was repaired primarily with video-assisted thoracoscopic surgery. The patient did not develop complications in the postoperative period and was discharged on Day 6. In conclusion, patients with non-small cell lung cancer invasive to the diaphragm can be even safely operated with the video-assisted thoracoscopic surgery.

Keywords: Diaphragm; invasion; non-small cell lung cancer; videoassisted thoracoscopic surgery..

Figure 1. Thoracic computed tomography and positron emission tomography-computed tomography images of the tumor before the neoadjuvant treatment. The tumor originated from right lower lobe had a maximum standardized uptake value of 9.4 with no lymph node involvement. The yellow arrow indicates the tumor.

Figure 2. Operational view of the tumor. (a) The tumor invading the diaphragm. (b) En bloc resection of tumor with the diaphragm. (c) Resulting defect on the diaphragm. (d) The view of the diaphragm repaired with primary suturing.

Figure 3. The chest radiograph of patient at the postoperative third month.