Video-assisted thoracoscopy for lung cancer: who is the future of thoracic surgery?

Jiang, Yu; Su, Zhan; Liang, Hengrui; Li, Jun; Liang, Wenhua; He, Jianxing

doi:10.21037/jtd-20-1116

Cited by 16 publications

(18 citation statements)

References 38 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Video-assisted thoracic surgery (VATS) lobectomy has become the standard procedure for treating early-stage non-small cell lung cancer (NSCLC) ( 1 ). Currently, for some specific early-stage lung cancer, VATS segmentectomy through fine anatomy can not only achieve the same therapeutic effect as VATS lobectomy but also further preserve normal lung tissue, thereby maximizing the preservation of lung function ( 2 ). However, the surgical difficulty and complexity of VATS segmentectomy are much higher than those of VATS lobectomy.…”

Section: Introductionmentioning

confidence: 99%

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

et al. 2022

View full text Add to dashboard Cite

BackgroundWith its growing popularity and potential outcome, preoperative three-dimensional reconstruction of chest computed tomography (CT) has been widely used in video-assisted thoracic surgery (VATS) segmentectomy for treating non-small cell lung cancer (NSCLC). This study aimed to summarize the experience of anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on the three-dimensional reconstruction of chest CT.Materials and methodsA total of 103 patients with early-stage NSCLC were chosen to undergo VATS segmentectomy based on preoperative three-dimensional reconstruction of chest CT in our institute from September 2019 to July 2022. Data such as clinical characteristics and variations in blood vessels and bronchi were reviewed in this study.ResultsThe branches of the left lingular pulmonary artery may mutate into the LS1 + 2 + 3. A1 + 2 has four subtypes. The distribution of variation is relatively balanced, and the most common variation is type I (35/103, 33.9%). Most lingular arteries originate from the oblique cleft side of the lingular bronchus (79/103,76.7%). Most V(1 + 2)c* are small developments (70/103, 68.0%). The venous return of the proper segment mainly depends on V(1 + 2)b + c. The variation in the left upper lobe bronchus is complex. The most common variant is the bifurcation type (type A to G, 92/103, 89.3%) and bifurcation type A (62/103, 60.2%). The posterior apical segment artery of the left upper lobe is not accompanied by its bronchus.ConclusionsThe variation types of blood vessels and bronchus in the upper lobe of the left lung are complex. Preoperative CT-based three-dimensional reconstruction of pulmonary arteries, veins, and bronchi is of great significance. It can help understand the variations, accurately locate lesions before the surgery, and effectively plan surgeries.

show abstract

Section: Introductionmentioning

confidence: 99%

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

et al. 2022

View full text Add to dashboard Cite

show abstract

“…A lobectomy is considered the gold standard of care for healthy individuals with early-stage lung cancer ( Hartwig and D'Amico, 2010 ). Modern surgical techniques, such as minimally invasive video-assisted thoracoscopic surgery (VATS) for lung resections, are enabling better prognosis for patients and better operation conditions for surgeons, redefining surgical fitness ( Jiang et al, 2020 ). In some studies, perioperative mortality and long-term survival following VATS lobectomy were found to be superior to those following open surgery ( Jones and Baldwin, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

“…The RATS system is comprised of a remote console and three or four robotic arms capable of simulating surgeon movements. In addition, it provides surgeons with a magnified three-dimensional (3D) and high-definition operation field, which enables them to perform more complex procedures ( Jiang et al, 2020 ). However, because of the novel surgical technique, the cost is higher.…”

Section: Introductionmentioning

confidence: 99%

Photodynamic therapy of lung cancer, where are we?

Crous

Abrahamse

2022

Front. Pharmacol.

View full text Add to dashboard Cite

Lung cancer remains the leading threat of death globally, killing more people than colon, breast, and prostate cancers combined. Novel lung cancer treatments are being researched because of the ineffectiveness of conventional cancer treatments and the failure of remission. Photodynamic therapy (PDT), a cancer treatment method that is still underutilized, is a sophisticated cancer treatment that shows selective destruction of malignant cells via reactive oxygen species production. PDT has been extensively studied in vitro and clinically. Various PDT strategies have been shown to be effective in the treatment of lung cancer. PDT has been shown in clinical trials to considerably enhance the quality of life and survival in individuals with incurable malignancies. Furthermore, PDT, in conjunction with the use of nanoparticles, is currently being researched for use as an effective cancer treatment, with promising results. PDT and the new avenue of nanoPDT, which are novel treatment options for lung cancer with such promising results, should be tested in clinical trials to determine their efficacy and side effects. In this review, we examine the status and future potentials of nanoPDT in lung cancer treatment.

show abstract

“…Robotic-assisted thoracic surgery (RATS), an innovative minimally invasive surgery system, provides a magnified, 3D, high-definition surgical field for operating surgeons, allowing them to perform complicated surgery without dissecting unnecessary surrounding tissue (4,5). Moreover, the maneuverability of the mechanical wrist, which is superior to that of human hand, makes radical lymphadenectomy easier (4,5). Therefore, RATS may be especially suitable for patients with nodal involved disease.…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted thoracic surgery reduces perioperative complications and achieves a similar long-term survival profile as posterolateral thoracotomy in clinical N2 stage non-small cell lung cancer patients: a multicenter, randomized, controlled trial

Huang¹,

Tian²,

Li³

et al. 2021

Transl Lung Cancer Res

View full text Add to dashboard Cite

Background: Our previous study demonstrated the safety and short-term efficacy of robotic-assisted thoracic surgery (RATS) in clinical N2 (c-N2) stage non-small cell lung cancer (NSCLC) patients. From this, the present study was devised, in which the follow-up time and sample size were both extended to explore the long-term efficacy and potential benefit in survival of RATS compared with lobectomy in c-N2 stage NSCLC patients.Methods: Patients with c-N2 NSCLS were randomly assigned in a 1:1 ratio to accept operation through thoracotomy or RATS. The da Vinci Surgical System (Si/Xi) was applied in the RATS group, while conventional lobectomy with a rib-spreading incision was applied in the posterolateral thoracotomy group.Primary endpoint was defined as disease free survival and overall survival (OS) of all recruited patients.Results: Compared with posterolateral thoracotomy group (N=72), the RATS group (N=76) had a reduced blood loss (P<0.001), decreased drainage duration (P=0.002), and decreased postoperative pain visual analog score (all P<0.001), but increased overall cost (P<0.001). Meanwhile, no difference in the other postoperative complications (such as air leakage, subcutaneous emphysema, atrial fibrillation etc.) was found between the RATS group and the posterolateral thoracotomy group (all P>0.05). Regarding long-term outcome, no difference in disease-free survival (DFS; P=0.925) or OS (P=0.853) was observed between the RATS group and posterolateral thoracotomy group. Subgroup analyses and multivariable Cox regression analyses also found no difference in DFS or OS between the RATS group and posterolateral thoracotomy groups.Conclusions: RATS reduced intraoperative bleeding, drainage duration, postoperative pain, and achieved similar long-term survival outcomes compared with posterolateral thoracotomy in c-N2 stage NSCLC patients.

show abstract

Video-assisted thoracoscopy for lung cancer: who is the future of thoracic surgery?

Cited by 16 publications

References 38 publications

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT

Photodynamic therapy of lung cancer, where are we?

Robotic-assisted thoracic surgery reduces perioperative complications and achieves a similar long-term survival profile as posterolateral thoracotomy in clinical N2 stage non-small cell lung cancer patients: a multicenter, randomized, controlled trial

Contact Info

Product

Resources

About