title: Microthoracoscopic one-port method for lung cancer.
abstract: OBJECTIVE
  We investigated whether the one-window method for thoracoscopic operations is possible as an operation for early-stage lung cancer.
  
  
  METHODS
  The subjects were the 40 patients in whom ND2 lymph node dissection was performed among those with a preoperative diagnosis of stage IA (T1 N0 M0) lung cancer who underwent thoracoscopic operations in our hospital during the 2-year period from January 2001 to December 2002. With the patient in the lateral position, a Thoraco Holder (Fuji Systems Corp, Tokyo, Japan) was inserted between the fourth and fifth intercostal space on the anterior axillary line. The surgeon used it as a port for performing the surgical maneuvers. An access needle was placed in the auscultatory triangle in the fifth intercostal space, and a 3-mm thoracoscope was used. Pulmonary lobectomy and mediastinal dissection were performed in the same manner as the standard thoracoscopic two-windows method.
  
  
  RESULTS
  The one-window technique was successful in 38 patients, and conversion to the two-windows method occurred in the other 2. Mean operation time was 2 hours 18 minutes. A mean number of 16.5 lymph nodes were removed, and mean blood loss was 22 mL. All 40 patients are alive and free of recurrence at 5 or more years since the operation.
  
  
  CONCLUSIONS
  As a result of mastering the operation and developing improved instruments, pulmonary lobectomies can now be performed by the one-window method. This method is the least invasive method of pulmonary cancer surgery available at the present time.
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan. iwasaki@is.icc.u-tokai.ac.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iwazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue