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Multicenter Study
. 1998 Dec;66(6):1903-8.
doi: 10.1016/s0003-4975(98)01166-7.

Is lobectomy by video-assisted thoracic surgery an adequate cancer operation?

R J McKenna Jr  1 , R K Wolf, M Brenner, R J Fischel, P Wurnig
Affiliations
Multicenter Study

Is lobectomy by video-assisted thoracic surgery an adequate cancer operation?

R J McKenna Jr et al. Ann Thorac Surg. 1998 Dec.

Abstract

Background: Although the public perceives video-assisted thoracic surgery (VATS) as advantageous because it is less invasive than a thoracotomy, the medical community has questioned the safety of VATS lobectomy and its adequacy as a cancer operation. Reported series have not been able to address these issues because follow-up has been only short-term.

Methods: A multiinstitutional, retrospective review was performed in 298 consecutive patients who underwent VATS for a standard anatomic lobectomy with lymph node dissection for lung cancer. Pathologic staging was I in 233 (78%), II in 27 (9%), and IIIA in 38 (13%) patients. Kaplan Meier survival analysis was performed.

Results: The conversion rate from VATS lobectomy to thoracotomy was 6%, but none were for massive intraoperative bleeding. The only death (0.3%) was because of mesenteric venous thrombosis. Forty minor complications occurred in 38 patients (12.8%) undergoing VATS. The mean and median lengths of stay were 5+/-3.39 and 4 days, respectively. Recurrence in an incision occurred in 1 patient (0.3%). The Kaplan Meier 4-year survival for stage I was 70%+/-5%.

Conclusion: The VATS lobectomy for bronchogenic carcinoma appears to be a safe operation, with the same survival as expected for a lobectomy done by thoracotomy.

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