Video-assisted Thoracoscopic Surgery Node Dissection for Lung Cancer Treatment

Overview

Journal Surg Today

Specialty General Surgery

Date 2017 Mar 13

PMID 28285463

Citations 7

Authors

Atsushi Watanabe

Masahiro Miyajima

Taijiro Mishina

Kodai Tsuruta

Yuki Takahashi

Ryunosuke Maki

Makoto Tada

Affiliations

Soon will be listed here.

Abstract

Purpose: Mediastinal node dissection (MND) is an integral component of the surgical treatment for non-small cell lung cancer (NSCLC). Although video-assisted thoracoscopic surgery (VATS) has been used increasingly for lung cancer treatment, the accuracy of by VATS MND still remains controversial. We reviewed the surgical results of VATS MND for NSCLC.

Methods: A systematic review of literature was performed, and articles that fully described the surgical procedure, devices, and results of VATS MND were selected to compare the efficacy of MND by VATS and thoracotomy.

Results: Various techniques and equipments have been shown to perform adequate MND, but there is an argument as to the method of estimation of the accuracy of MND. Most of the recent studies showed that the nodal upstaging and number of dissected nodes are significantly lower by VATS than after thoracotomy. Oppositely, some studies showed VATS noninferiority in these issues. Complications such as chylothorax, pleural effusion, bleeding, and nerve damage were similar in both groups.

Conclusions: Although ND by VATS remains controversial, VATS MND is becoming easier and more feasible owing to the development of more advanced endoscopic cameras and equipments. We should learn further to become more adept at performing adequate ND by VATS.

Citing Articles

Comprehensive assessment of risk factors and pathogenic characteristics of wound infections following thoracoscopic radical resection for lung cancer.

Xu J, Zhu J Int Wound J. 2024; 21(4):e14830.

PMID: 38531534 PMC: 10965314. DOI: 10.1111/iwj.14830.

Assessment of Feasibility and Prognostic Value of Sentinel Lymph Node Identification by Near-Infrared Fluorescence in Non-Small Cell Lung Cancer in Patients Undergoing Robotic Anatomic Lung Resections.

Forcada C, Gomez-Hernandez M, Fuentes M, Rivas C, Jimenez M Open Respir Arch. 2023; 5(4):100273.

PMID: 37818450 PMC: 10560828. DOI: 10.1016/j.opresp.2023.100273.

Number of lymph nodes dissected and upstaging rate of the N factor in robot-assisted thoracic surgery versus video-assisted thoracic surgery for patients with cN0 primary lung cancer.

Shindo Y, Miyajima M, Nakamura Y, Chiba Y, Arai W, Aoyagi M Surg Today. 2022; 53(4):428-434.

PMID: 36083513 DOI: 10.1007/s00595-022-02578-5.

Analysis of perioperative complications and related risk factors of thoracotomy and complete video-assisted thoracoscopic surgery lobectomy.

Su H, Yan G, Li Z, Fu L, Li L Am J Transl Res. 2022; 14(4):2393-2401.

PMID: 35559392 PMC: 9091098.

Complete Video-Assisted Thoracoscopic Surgery and Traditional Open Surgery for Elderly Patients With NSCLC.

Mao Y, Gao Z, Yin Y Front Surg. 2022; 9:863273.

PMID: 35372482 PMC: 8971185. DOI: 10.3389/fsurg.2022.863273.

References

Sagawa M, Sato M, Sakurada A, Matsumura Y, Endo C, Handa M . A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery: can it be perfect?. Ann Thorac Surg. 2002; 73(3):900-4. DOI: 10.1016/s0003-4975(01)03409-9. View

Wang W, Yin W, Shao W, Jiang G, Wang Q, Liu L . Comparative study of systematic thoracoscopic lymphadenectomy and conventional thoracotomy in resectable non-small cell lung cancer. J Thorac Dis. 2014; 6(1):45-51. PMC: 3895592. DOI: 10.3978/j.issn.2072-1439.2014.01.07. View

Howington J, Blum M, Chang A, Balekian A, Murthy S . Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl):e278S-e313S. DOI: 10.1378/chest.12-2359. View

Witte B, Messerschmidt A, Hillebrand H, Gross S, Wolf M, Kriegel E . Combined videothoracoscopic and videomediastinoscopic approach improves radicality of minimally invasive mediastinal lymphadenectomy for early stage lung carcinoma. Eur J Cardiothorac Surg. 2008; 35(2):343-7. DOI: 10.1016/j.ejcts.2008.09.044. View

Merritt R, Hoang C, Shrager J . Lymph node evaluation achieved by open lobectomy compared with thoracoscopic lobectomy for N0 lung cancer. Ann Thorac Surg. 2013; 96(4):1171-1177. DOI: 10.1016/j.athoracsur.2013.05.044. View

Baste J, Haddad L, Melki J, Peillon C . Anterior subcarinal node dissection on the left side using video thoracoscopy: an easier technique. Ann Thorac Surg. 2015; 99(4):e99-e101. DOI: 10.1016/j.athoracsur.2014.12.078. View

De Leyn P, Lardinois D, Van Schil P, Rami-Porta R, Passlick B, Zielinski M . European trends in preoperative and intraoperative nodal staging: ESTS guidelines. J Thorac Oncol. 2007; 2(4):357-61. DOI: 10.1097/01.JTO.0000263722.22686.1c. View

Lin Z, Xu S, Wang Q . Uniportal video-assisted thoracoscopic surgery right upper lobectomy with systematic lymphadenectomy in a semiprone position. J Thorac Dis. 2015; 6(12):1840-2. PMC: 4283289. DOI: 10.3978/j.issn.2072-1439.2014.11.22. View

Paul S, Sedrakyan A, Chiu Y, Nasar A, Port J, Lee P . Outcomes after lobectomy using thoracoscopy vs thoracotomy: a comparative effectiveness analysis utilizing the Nationwide Inpatient Sample database. Eur J Cardiothorac Surg. 2012; 43(4):813-7. DOI: 10.1093/ejcts/ezs428. View

10.

Whitson B, Andrade R, Boettcher A, Bardales R, Kratzke R, Dahlberg P . Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer. Ann Thorac Surg. 2007; 83(6):1965-70. DOI: 10.1016/j.athoracsur.2007.01.049. View

11.

Watanabe A, Mishina T, Ohori S, Koyanagi T, Nakashima S, Mawatari T . Is video-assisted thoracoscopic surgery a feasible approach for clinical N0 and postoperatively pathological N2 non-small cell lung cancer?. Eur J Cardiothorac Surg. 2008; 33(5):812-8. DOI: 10.1016/j.ejcts.2008.01.064. View

12.

McKenna Jr R, Houck W, Fuller C . Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg. 2006; 81(2):421-5. DOI: 10.1016/j.athoracsur.2005.07.078. View

13.

Amer K, Khan A, Singh N, Addis B, Jogai S, Harden S . Video-assisted thoracic surgery systematic mediastinal nodal dissection and stage migration: impact on clinical pathway. Eur J Cardiothorac Surg. 2011; 40(6):1474-81. DOI: 10.1016/j.ejcts.2011.02.072. View

14.

De Giacomo T, Venuta F, Rendina E . Role of lymphadenectomy in the treatment of clinical stage I non-small cell lung cancer. Thorac Surg Clin. 2007; 17(2):217-21. DOI: 10.1016/j.thorsurg.2007.03.008. View

15.

Scott W, Allen M, Darling G, Meyers B, Decker P, Putnam J . Video-assisted thoracic surgery versus open lobectomy for lung cancer: a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg. 2010; 139(4):976-81. DOI: 10.1016/j.jtcvs.2009.11.059. View

16.

Muranishi Y, Sonobe M, Menju T, Aoyama A, Chen-Yoshikawa T, Sato T . Atrial fibrillation after lung cancer surgery: incidence, severity, and risk factors. Surg Today. 2016; 47(2):252-258. DOI: 10.1007/s00595-016-1380-y. View

17.

Lin Z, Xi J, Xu S, Jiang W, Wang L, Wang Q . Uniportal video-assisted thoracic surgery lobectomy in semiprone position: primary experience of 105 cases. J Thorac Dis. 2016; 7(12):2389-95. PMC: 4703695. DOI: 10.3978/j.issn.2072-1439.2015.12.60. View

18.

Sato Y, Tezuka Y, Kanai Y, Otani S, Yamamoto S, Tetsuka K . Novel retractor for lymph node dissection by video-assisted thoracic surgery. Ann Thorac Surg. 2008; 86(3):1036-7. DOI: 10.1016/j.athoracsur.2008.04.002. View

19.

Zhong C, Yao F, Zhao H . Clinical outcomes of thoracoscopic lobectomy for patients with clinical N0 and pathologic N2 non-small cell lung cancer. Ann Thorac Surg. 2012; 95(3):987-92. DOI: 10.1016/j.athoracsur.2012.10.083. View

20.

Watanabe A, Nakazawa J, Miyajima M, Harada R, Nakashima S, Mawatari T . Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg. 2012; 24(1):68-73. DOI: 10.1053/j.semtcvs.2012.03.002. View