Video-Assisted Thoracic Surgery Lobectomy: Report of CALGB 39802—A Prospective, Multi-Institution Feasibility Study

Abstract

A standardized approach to VATS lobectomy as specifically defined with avoidance of rib spreading is feasible.

Thoracoscopic lobectomy for locally advanced-stage non-small cell lung cancer is a feasible and safe approach: analysis from multi-institutional national database

“…Almost 25% of patients had chemotherapy before surgery, but in this cohort, we included different cases that could be differently evaluated on the basis of the clinical experience of the recruiting centre. The initial doubts about VATS-L oncological adequacy for early-stage NSCLC have been overcome, as demonstrated by several authoritative papers (1)(2)(3)(4)(5)(6)(7)(8)(9)(10); the minimally invasive technique and the traditional open technique have proven to be equivalent in terms of overall survival and disease free-survival also for locally advanced NSCLC (10)(11)(12)(13). Unfortunately, our study lacks of mid-and long-term survival results; however, we have some valid oncological data such as the extent of lymphadenectomy and the resection margin status.…”

“…Recent analysis of post-operative outcomes performed on both single institutional series and official databases proposed VATS-L to be superior in terms of length of stay, post-operative pain, preserving pulmonary function, postoperative complications and compliance with adjuvant chemotherapy when compared to open lobectomy (1)(2)(3)(4)(5)(6). Moreover, VATS-L has been recommended by National Comprehensive Cancer Network (NCCN) guidelines as the preferred approach for early-stage NSCLC (15).…”

“…Video-assisted thoracoscopic lobectomy (VATS-L) is a well-established approach for early-stage non-small cell lung cancer (NSCLC) (1)(2)(3) and is associated with a shorter length of stay, less post-operative pain, preserved pulmonary function, fewer post-operative complications and better compliance with adjuvant chemotherapy than lobectomy via thoracotomy (4)(5)(6). Furthermore, several and authoritative authors demonstrated the efficacy of VATS lobectomy in terms of oncological results and validity of mediastinal intra-operative staging (7)(8)(9)(10), but the use of VATS-L for locally advanced-stage NSCLC is not well established.…”

Video-assisted thoracoscopic surgery lobectomy learning curve: what program should be offered in a residency course?

“…Video-assisted thoracoscopic surgery (VATS) is nowadays considered an acceptable approach for treating early stage of non-small cell lung cancer (NSCLC) (1,2), as recommended by current evidence-based guidelines from the American College of Chest Physicians (3). As a result, VATS has progressively emerged as a gold standard for treatment of both benign (i.e., pneumothorax, stage II-III pleural empyema) and malignant thoracic diseases (i.e., lung cancer, esophageal cancer, mediastinal tumors), by substituting classical approaches, such as thoracotomies, thanks to an increasing and established evidence of several advantages.…”

VATS right upper lobe bronchial sleeve resection

“…With the development of video-assisted thoracoscopy surgery (VATS), locally advanced lung cancer, has been adapted for thoracoscopic lung resection and has obtained worldwide acceptance (4)(5)(6)(7)(8)(9)(10). However, central lung cancer was still considered a contraindication of thoracoscopic surgery (11,12). Thoracoscopic bronchial sleeve resection has only been reported in limited studies (13)(14)(15)(16).…”