Sleeve lobectomy by video-assisted thoracic surgery versus thoracotomy for non-small cell lung cancer.

Shijie Zhou,Zhidong Liu,Guotian Pei,Ning Xiao,Yi Han,Xiaoyun Song,Shaofa Xu,Shuku Liu,Daping Yu,Yunsong Li

doi:10.1186/s13019-015-0318-6

Abstract

BackgroundBoth video-assisted thoracic surgery (VATS) and thoracotomy are used for sleeve lobectomy for patients with non-small cell lung cancer (NSCLC). This retrospective study aimed to assess the safety and efficacy of VATS sleeve lobectomy for NSCLC patients.MethodsBetween May 2009 and May 2013, 51 sleeve lobectomies (10 by VATS and 41 by thoracotomy) were performed for patients with NSCLC. Operative characteristics and postoperative course were compared between two groups.ResultsPatient demographics were similar between the two groups. Thoracotomy patients had larger tumors compared with VATS patients (p = 0.02). VATS patients had a longer operating time (p < 0.001) but a shorter length of postoperative hospital stay (p = 0.009). The two groups did not differ in pathologic stage, histologic results, blood loss, ICU stay, amount of chest drainage, duration of chest drainage, numbers and distributions of dissected lymph nodes and the occurrence of complications. There were no perioperative deaths in the VATS group, whereas there was one death (2.4 %) in the thoracotomy group. There were no conversions to thoracotomy in the VATS group. The overall median survival between the two groups was similar (3.2 years VATS versus 3.2 years thoracotomy, log-rank p = 0.58).ConclusionsVATS sleeve lobectomy for the treatment of NSCLC is technically feasible and safe and is associated with comparable complication rates and survival compared with thoracotomy approach, but it deserves further investigation in large series.

Highlights

Both video-assisted thoracic surgery (VATS) and thoracotomy are used for sleeve lobectomy for patients with non-small cell lung cancer (NSCLC)
Patients We retrospectively reviewed the files of 10 patients who underwent a sleeve lobectomy for non-small cell lung cancer (NSCLC) by the VATS approach in the Department of Thoracic Surgery at Beijing Chest Hospital, Capital Medical University, between May 2009 and May 2013
Thoracotomy patients had larger tumors compared with VATS patients (p = 0.02)

Summary

Introduction

Both video-assisted thoracic surgery (VATS) and thoracotomy are used for sleeve lobectomy for patients with non-small cell lung cancer (NSCLC). This retrospective study aimed to assess the safety and efficacy of VATS sleeve lobectomy for NSCLC patients. Videoassisted thoracic surgery (VATS) is regarded as a minimally invasive procedure with good long-term survival outcomes [5], many surgeons considered that sleeve resection was an absolute contraindication for VATS lobectomy. We conducted a retrospective study to examine the safety and efficacy of the video-assisted technique in the performance of sleeve lobectomies for NSCLC patients and to compare the outcome from these procedures with that from sleeve lobectomies performed through a standard thoracotomy.

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Discussion

Conclusion