title: Video-assisted thoracic surgery for lung cancer: republication of a systematic review and a proposal by the guidelines committee of the Japanese Association for Chest Surgery 2014.
abstract: BACKGROUND
  Patients with early-stage non-small cell lung cancer (NSCLC) are candidates for surgical intervention with curative intent. For these early-stage lung cancer surgeries, video-assisted thoracic surgery (VATS) is considered. The purpose of this article is to propose a recommendation for this according to the evidence and provide information for patients with operable early-stage lung cancer from the Japanese Association for Chest Surgery. The clinical question here is whether VATS lobectomy is recommended for patients with clinical stage I NSCLC.
  
  
  METHODS
  The Japanese Association for Chest Surgery guidelines committee reviewed and summarized the available literature and assessed the quality of the evidence. The available literature on VATS was examined using references from MEDLINE. The recommendations were provided according to the Medical Information Network Distribution Service in Japan (Minds).
  
  
  RESULTS
  VATS lobectomy may be considered and applied to patients with clinical stage I NSCLC; however, well-established evidence is lacking. VATS showed better or at least equivalent outcomes regarding intra- or postoperative complications compared with thoracotomy, with less invasiveness. Additionally, long-term survival by VATS lobectomy was suggested to be at least equivalent, although there is a lack of evidence.
  
  
  CONCLUSIONS
  VATS lobectomy by an experienced surgeon is associated with minimal invasiveness and an outcome equivalent to that of open lobectomy in stage I NSCLC. (Recommendation grade: Level C1).
authors.affiliation: Guidelines Committee of Japanese Association for Chest Surgery, Tokyo, Japan, yamashi1@fukuoka-u.ac.jp.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Yamashita
authors.forename: Taichiro
authors.initials: T
authors.lastname: Goto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mori
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Horio
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kadota
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwasaki
mesh_terms: D000369:Aged, 80 and over; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000601:surgery*; D010506:Periodicals as Topic; D011013:Pneumonectomy / Q000379:methods* / Q000592:standards; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D013903:Thoracic Surgery; D020775:Thoracic Surgery, Video-Assisted / Q000592:standards*