Lobektomia VATS – nowa metoda leczenia chirurgicznego chorych na niedrobnokomórkowego raka płuca w I stopniu zaawansowania klinicznego
Anatomical, video assisted thoracic surgery (VATS) is a surgical technique performed in leading thoracic centers for the treatment of primary early stage lung cancer and benign lung diseases. Early results of VATS lobectomies performed between June 2009 and June 2010 in Thoracic Surgery Departament, Medical University of Gdansk were analysed.
Results: Initially 69 patients underwent surgery with an intention to perform VATS lobectomy. Conversion to conventional surgery happened in 9 cases due to dense adhesions (5 pts), hilar lymphnode swelling (3 pts) and faulty stapler (1 pt). Failed placement of the double lumen endotracheal tube prevented performance of 16 VATS procedures. Finally 60 patients (25 females) were analysed, of the mean age of 63.4 years (between 39 and 79 years). Fifty four primary lung cancers, 1 metastatic breast cancer and 5 benign lesions were diagnosed. Mean duration of lobectomy was 195 min (from 130 min to 360 min) and mean hospitalisation was 8.7 days. The morbidity and mortality rate was respectively 18.3%. and 0%.
Conclusions: VATS lobectomy is a safe procedure in the early stage of primary lung cancer. Early results are comparable to the results presented in publications concerning classic thoracotomy. VATS lobectomy is a less painful procedure with better cosmetic results compared to data in publications concerning classic thoracotomy. An experienced anesthesiologist is mandatory to succeed in VATS lobectomy operations. The long process of surgeons’ training and the lack of specially designed instruments and staplers is a major disadvantage of videothoracoscopy.