Survey of totally thoracoscopic anatomic segmentectomy for the peripheral stage I A non small cell lung cancer

Abstract

Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy （TIAS） for the treatment of the peripheral stage I A non small cell lung cancer（NSCLC）. Methods The study involved 50 consecutive patients undergoing totally thoracoseopic anatomic segmentectomy （TTAS） from September 2010 to November 2012 in the First People＇s Hospital affiliatied to Nanjing Medical University. The diameter of the tumors were less than 2 em [ （ mean diameter（ 1.35 ±0.48） cm]. All lymph node sampling of N1 and N2 were neglive, All patients received symtematic lymph node dissection. The pulmonary vessels were individually ligated, and the bronchi were closed using an endoscopic stapler. The intersegmental plane was identified using the demarcation between the resected（inflated） and preserved（collapsed） lungs. Sta- plers were used for intersegmental dissection. Results The mean operative time and intraoperative bleeding were （ 191.5 ± 50.4） min and （49.2 ± 54.6） ml respectively. The chest tube drainage duration was （ 3 ± 1 ） days. The number of stapler car- tridges used for intersegmental division was 3.9 ±0.8. The mean number of lymph nodes and nodal stations dissected were 12. 6± 2.8 and 6.0 ± 1.5 respectively. No mortality and complications were observed 30 days after the surgery. Further, no local recurrence or metastases were observed during follow-up. Conclusion Totally thoracoscopic anatomic segmentectomy （TrAS） is a feasible and safe technique. With systematic lymph node dissection, TFAS can be a reasonable therapeutic option for stage I a NSCLC. Key words: Thoracoscopy Pneumonectomy Lung neoplasms