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Vol.45 No.3 contents | Japanese/English |
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Video Assisted Thoracic Surgery (VATS) Lobectomy Combined With Lymphadenectomy as a New Modality for the Treatment of Lung Cancer
Shizuka Kaseda11National Hospital Organization Kanagawa Hospital, Japan
Objective. The long-term result of video-assisted thoracic surgery (VATS) lobectomy combined with lymphadenectomy, was evaluated as a new modality for the treatment of lung cancer. Materials and Methods. Between September 1992 and August 2004, we performed 378 VATS lobectomies. Of the 324 cases of lung cancer, 247 clinical stage I patients with no major complications underwent extended lymph node dissection (lymphadenectomy). Results. The number of resected lymph nodes ranged from 5 to 73 (25 on average). Among these 247 patients, pathological examination revealed N0 in 159 patients (64.4%), N1 in 32 patients (13.0%), and N2 in 56 (22.6%), and 152 were finally diagnosed as pathologically stage I. Among these patients, 5 died of multiple bone metastases, pleuritis carcinomatosa or brain metastasis. However, the remaining patients are alive with no signs of metastasis for 1 to 130 months after the operation. The 5-year and 10-year survival rates after VATS lobectomy combined with lymphadenectomy for pathological stage I lung cancer have been 94.4% and 87.9%, respectively, which are far better than those after open surgery (78.5% and 65.0%). Comparison between pre- and post-operative pulmonary function revealed less of a decrease for VATS compared with open thoracotomy; in the VATS group, the 3-year postoperative scores were 0.92 for vital capacity and 0.88 for FEV1.0. Conclusion. VATS was evaluated as setting a new gold standard in the treatment of lung cancer in appropriate patients.
key words: Thoracoscope, Lung cancer, Lobectomy, Lymphadenectomy, VATS
JJLC 45 (3): 255-260, 2005
