title: Minimally invasive video-assisted thoracoscopic lobectomy for better clinical outcomes in peripheral T1NO lung cancer.
abstract: It is an unresolved issue whether various thoracotomies affect clinical outcomes. In addition, a wide variety of technical approaches of video-assisted thoracic surgery depend on the facility. We reviewed 152 consecutive patients with clinical T1N0M0 lung cancer that underwent three types of lobectomy with systematic mediastinal lymphadenectomy in a single institute: 46 conventional thoracotomies (OPEN), 50 anterolateral small thoracotomies mainly using the thoracoscope as a light guide (ASSIST), and 56 minimum thoracotomies in which only a thoracoscope view was used (PURE). Total discharge from the chest drainage tube, length of hospital stay, and post-thoracotomy pain were significantly less in PURE than in OPEN and ASSIST. The results of mediastinal lymphadenectomy were equivalent. The 3-year survival rates were also similar among the three groups. We conclude that good clinical outcomes, especially reduced post-thoracotomy pain, seemed to correlate with the lesser degree of destruction of the chest wall with the identical quality as an acceptable cancer operation in PURE.
authors.affiliation: Department of Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan. yosy.811kob@k3.dion.ne.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Yamashita
authors.forename: H
authors.initials: H
authors.lastname: Mukaida
authors.forename: W
authors.initials: W
authors.lastname: Takiyama
authors.forename: N
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: K
authors.initials: K
authors.lastname: Hisamatsu
authors.forename: S
authors.initials: S
authors.lastname: Saeki
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: R
authors.initials: R
authors.lastname: Sakabe
authors.forename: M
authors.initials: M
authors.lastname: Tokunaga
authors.forename: T
authors.initials: T
authors.lastname: Yoshiyama
authors.forename: Y
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: S
authors.initials: S
authors.lastname: Shimizu
authors.forename: Y
authors.initials: Y
authors.lastname: Hino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome