Video-assisted thoracoscopic surgery (VATS) segmentectomy for small peripheral lung cancer tumors: intermediate results |
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Authors: | Email author" target="_blank">T?ShiraishiEmail author T?Shirakusa A?Iwasaki M?Hiratsuka S?Yamamoto K?Kawahara |
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Institution: | (1) Second Department of Surgery, Fukuoka Univeristy School of Medicine, 7-45-1 Nanakuma, Jonan-ku, 814-0180 Fukuoka City, Fukuoka, Japan |
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Abstract: | Background We investigated the feasibility and suitability of video-assisted thoracoscopic surgery (VATS) segmentectomy for curing selected
non-small cell lung cancer (NSCLC) with this less invasive technique
Methods We performed VATS segmentectomy for small (<20 nm) peripherally located tumors and pathologically confirmed lobar lymph node-negative
disease by frozen-section examination during surgery. Of the 34 patients who underwent this limited resection, 22 were treated
with complete hilar and mediastinal lymph node dissection (intentional group), whereas 12 patients who were deemed to be high
risk in their toleration for lobectomy underwent VATS segmentectomy with incomplete hilar and mediastinal lymph node dissection
(compromised group). The surgical and clinical parameters were evaluated and compared with those of segmentectomy under standard
thoracotomy to evaluate the technical feasibility of VATS segmentectomy.
Results We found that VATS segmentectomy could be performed safely with a nil mortality rate and acceptably low morbidity. The mean
period of observation was relatively short at 656.7±572.1 and 783.4±535.8 days in the intentional and compromised groups,
respectively. At the time of writing, all intentional patients remain alive and free of recurrence. There were two cases of
non-cancer-related death in the compromised group. Clinical data indicated that VATS segmentectomy caused the same number
or fewer surgical insults compared with segmen-tectomy under standard thoractomy
Conclusions The present results are intermediate only; the rate of long-term survival and the advantages of the less invasive procedure
still need further investigation. Nevertheless, we believe that VATS segmentectomy with complete lymph node dissection is
a reasonable treatment option for selected patients with small peripheral NSCLC. |
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Keywords: | Video-assisted thoracoscopic surgery (VATS) Primary lung cancer Segmentectomy Limited resection Minimally invasive surgery Cancer |
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