A Clinical Evaluation of Video-assisted Thoracic Surgery for Lung Cancer With an Auscultatory Triangle Approach.

Abstract

-Objective. Recently, lobectomy by video-assisted thoracic surgery (VATS lobectomy) has been adopted by many institutions because of its less invasive approach for small peripheral lung cancer. The purpose of this retrospective study was to evaluate the practical applicability of the auscultatory triangle approach in VATS lobectomy. Methods. From February 1998 to March 2002, a total of 59 patients with clinical T1NOMO or T2NOMO lung cancer underwent lobectomy with lymphadenectomy in our hospital. Of these, 31 underwent VATS lobectomy (VL group), and 28 underwent standard thoracotomy (ST group). In the VL group, a small incision measuring 6 cm was made for minithoracotomy in the chest above the auscultatory triangle by a muscle-sparing procedure. Next, the fourth or fifth intercostal space (ICS) was entered without rib resection. After starting with dissection of the lymph nodes of the upper mediastinal space, hilar dissection was performed with conventional thoracotomy instruments. Pulmonary arteries and veins were then divided prior to endoscopic stapling. After stapling of the vessels and bronchus, the resected pulmonary