Analysis to 34 cases of video-assisted mini-thoracotomy for radical resection of lung carcinoma

Abstract

Objective To assesss the value of video-assisted mini-thoracotomy for radical resection of lung carcinoma. Methods From July 2004 to July 2009,34cases of radical resection of lung carcinomo were operated by video-assisted mini-thoracotomy.Of the patients,2 cases were in stage ⅠA,2 cases in stage ⅠB, 11 cases in stage Ⅱ A,13 cases in stage Ⅱ B and 6 cases in stage Ⅲ A. 27 cases were peripheral lung cancer and 7 cases central cancer. Under general anesthesia,double-lumen endotracheal intubation is achieved. One access port for the insertion of a thoracoscope is placed with a 2.0cm -long incision in the eighth or ninth intercostal space over the midaxillary line. An additional transverse skin incision 4.0 to 10.0cm long for access thoracotomy is made over the midaxillary line in the fourth or fifth interspace.The rsected lobe is removed through the mini-incision. Lymph nodes are dissected routinely.Results Upper right lobectomy was carried out in 7 patients(including 2 cases of sleeve lobectomy),right middle lobectomy 2 cases,lower right lobectomy 5 cases,upper left lobectomy 8 cases and lower left lobectomy 12 cases.The mean operation time was 65～220min[(105 ± 28)min].The mean blood loss in operation was 100～450 ml[(190 ± 55)ml]. Postoperatinely,the chest drainage was 240～650 ml [(360 ± 110)ml] and thrombus of right femoral occurred in 1 case.The patients were discharged from the hospital in 6～9 days after the surgery and followed up for 2～60 months .Of these patients 2 patients lost following up and 10 cases died in cancer recurrence or metastasis. Conclusions Video-assisted mini-thoracotomy for radical resection of lung carcinoma is a feasible and safe procedure,is to expand the appropriate use of VATS lobectomy and conventional lobectomy and has some indications. Key words: Video-assisted mini-thoracotomy; Lobetomy; Lung cancer