A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer--technique, feasibility, and advantages.
BACKGROUND
A completely thoracoscopic lobectomy/segmentectomy for primary lung cancer was designed to maximize the benefits of this type of minimally invasive surgery. The technique, feasibility, and advantages of this surgical modality over the conventional procedure were investigated.


METHODS
Between January 2003 and December 2004, 38 patients underwent a lobectomy (n = 30) or segmentectomy (n = 8) for clinical stage IA primary lung cancer. A resection using a standard thoracotomy (Thoracotomy Group) was performed in 19 patients, and a completely thoracoscopic resection was performed in 10 cases (CTR Group). Conventional video-assisted thoracic surgery with a mini-thoracotomy was performed in 9 cases.


RESULTS
All CTR lobectomies or segmentectomies were carried out safely without any major complications. The number of resected mediastinal lymph nodes was similar in both groups. There was a tendency for the hospital stay to be somewhat shorter in the CTR Group. With respect to postoperative pain as evaluated by a visual analogue scale (VAS), the CTR Group showed a significantly lower level of pain in comparison to the Thoracotomy Group ( P = 0.024 on day 2).


CONCLUSIONS
We concluded that a complete thoracoscopic lung resection is a safe and technically feasible surgical procedure which enables us to make thoracoscopic lung resections less invasive.
Shiraishi
T
T
Department of Surgery II, Fukuoka University School of Medicine, Fukuoka, Japan. tshiraishi-ths@umin.ac.jp
Shirakusa
T
T
Miyoshi
T
T
Hiratsuka
M
M
Yamamoto
S
S
Iwasaki
A
A
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D015916:Drainage, Postural; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D007958:Leukocyte Count; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011013:Pneumonectomy / Q000295:instrumentation / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein