[Evaluation of thoracoscopic surgery with mini-thoracotomy for primary lung cancer--as seen from the angle of lymph node dissection].
The extent of thoracoscopic surgery using a mini-thoracotomy for radical lung cancer surgery was investigated with regard to practical applicability. Thirteen patients with lung cancer underwent video-assisted lobectomy or segmentectomy and lymph node dissection through a 6-8 cm mini-thoracotomy. Eleven of thirteen cases were able to undergo video-assisted lobectomy and segmentectomy, but in one patient with strong adhesion and one patient who developed hemorrhage due to pulmonary arterial injury, thoracotomy was extended to 15-20 cm. Ten patients with lung cancer who underwent lobectomy under standard thoracotomy, underwent lymph node dissection under simulated 6-8 cm mini-thoracotomy. These ten cases and five cases who underwent lymph node dissection under 6-8 cm mini-thoracotomy were then switched over to standard thoracotomy to examine the possibility of residual lymph nodes. On the right-side, R2 lymph node dissection was practical, but on the left-side, #3, 3p, 4, 7 lymph node dissections were insufficient or impractical in some cases. The above results suggested that right-sided lobectomy is practical for radical thoracoscopic surgery with a mini-thoracotomy is practical for up to stage II. However, on the left side, the procedure should be confined to stage I.
Urakami
T
T
Department of Respiratory Surgery, Toyota Memorial Hospital, Aichi, Japan.
Kondo
K
K
Kobayashi
T
T
Kasugai
T
T
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D013906:Thoracoscopy; D013908:Thoracotomy / Q000379:methods*