title: [Complete Video-assisted Thoracic Surgery for Lung Cancer].
abstract: Video-assisted thoracic surgery(VATS) lobectomy is currently accepted as an appropriate minimally invasive procedure for selected patients with early-stage non-small cell lung cancer(NSCLC). Complete VATS is defined as an operation in which no rib spreader is used and visualization is only through the video monitor, and not through the incisions. We perform complete VATS lobectomy via 5 ports since the assistant surgeon can use 2 instruments to provide a good operative field. Our indication for complete VATS lobectomy is not limited to early-stage NSCLC but also includes N1-2 disease. The overall 5-year survival rate in patients with N2 disease was 59% and the recurrence-free 5-year survival rate was 34% during a median follow-up of 54 months. In some experienced institutions, the indications for VATS in NSCLC are now expanding to various complex procedures such as pneumonectomy, sleeve lobectomy, en bloc chest wall resection, and reconstruction of the pulmonary artery. Except for simple pulmonary artery reconstruction, we have not yet used VATS for more complex surgical procedures, since it is still unclear whether VATS is superior in terms of degree of surgical invasiveness and oncological efficacy when compared with thoracotomy.
authors.affiliation: Department of Thoracic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Tsubochi
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung; D006801:Humans; D008175:Lung Neoplasms; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome