title: Video-assisted thoracoscopic lobectomy for clinical stage I non-small cell lung cancer: experience with 111 consecutive patients demonstrating comorbidity.
abstract: OBJECTIVE
  The outcomes of video-assisted thoracoscopic lobectomy for clinical stage I non-small cell lung cancer (NSCLC) patients with comorbidities were examined to determine the technical feasibility and safety of this procedure.
  
  
  METHODS
  Between January 2002 and December 2007, 111 consecutive patients with suspected stage I lung cancer, who individually had one or more comorbidities cited in the modified Kaplan-Feinstein Index, were scheduled for a video-assisted thoracoscopic lobectomy. The demographic, perioperative, and outcome variables were assessed.
  
  
  RESULTS
  One hundred of 111 patients had non-small cell lung cancer. Ninety-nine patients underwent successful video-assisted thoracoscopic lobectomies, while there was one conversion because of a hemorrhage from the pulmonary artery in the early stage. Including this one conversion, no patients required a blood transfusion during surgery or postoperatively. There were no intraoperative or in-hospital deaths. No complications occurred in 78 (78.8%) of 99 patients. Only one patient (1.0%) with a Kaplan-Feinstein Index Score of severe grade contracted pneumonia indicating grade 3 (severe), whereas the remaining 20 patients had grade 1 (mild) or 2 (moderate) complications. At a median follow-up of 40 months, the overall 3-year survival rates for postoperative stage IA (N.=52); IB (N.=26); and II or more (N.=21) were 100%; 78%; and 71%, respectively.
  
  
  CONCLUSIONS
  A video-assisted thoracoscopic lobectomy is therefore considered to be a feasible and safe procedure for clinical stage I NSCLC even in patients with comorbidities.
authors.affiliation: Department of Thoracic Surgery, Federation of National Public Service Personnel Mutual Aid Associations, Kitakyushu, Japan. ryoichi@med.uoeh-u.ac.jp
authors.forename: R
authors.initials: R
authors.lastname: Nakanishi
authors.forename: M
authors.initials: M
authors.lastname: Nakagawa
authors.forename: H
authors.initials: H
authors.lastname: Tokufuchi
authors.forename: T
authors.initials: T
authors.lastname: Okumura
authors.forename: M
authors.initials: M
authors.lastname: Maeda
authors.forename: S
authors.initials: S
authors.lastname: Kuboi
authors.forename: M
authors.initials: M
authors.lastname: Kido
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000601:surgery*; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D016896:Treatment Outcome