PURPOSE: VATS lobectomy is a safety minimal-invasive technique for the operative treatment of NSCLC and is been accepted as an equally good therapeutical approach in surgical centers with skilled VATS surgeons. Nevertheless long-time results are rare.
METHODS: Between 5/2003 and 3/2006 we performed 56 VATS lobectomies with systematic mediastinal lymphnode dissection for non-small lung cancer. 12 female and 44 male, 56 respectively 62 years, with preoperative stage T1/T2 N0 lung cancer were treated. No conversion to a thoracotomy occurred. The postoperative stage was: IA n= 46, IB n=7, IIA n=2, IIB n=1. The resections performed were: left upper lobe n= 26, right upper lobe n=17, middle lobe n= 4, left lower lobe n=5, right lower lobe n=4. Video-Mediastinoscopy was perfomed for every case of preoperative verified left sided cancer.
RESULTS: The mean length of surgical procedure was 94 min (39-154 min). The perioperative blood-loss was between 120 to 500 ml. No intraoperative complications were recorded. Postoperatively 6 patients developed complications: pneumonia n=2, atrial fibrillation n=1, atelectasis n=2, re-operation n=1 (clipping of a bleeding from a mediastinal vessel). The postoperative length of hospital-stay was 5.6 days (3-9 d). No patient died.
CONCLUSION: Although VATS lobectomy for lung cancer is certainly an advanced video procedure it is a serious alternative to the lobectomy via thoracotomy. Technically the operation and especially the lymphnode dissection could be done equal and with identically oncological quality. With shorter length of hospital stay and shorter time for recovery VATS lobectomy is an alternative operative approach for the management of NSCLC.
CLINICAL IMPLICATIONS: We recommended VATS lobectomy for selected patients with non small cell lung cancer preoperative Stage I and II.
DISCLOSURE: Erich Hecker, None.