Contemporary Video-Assisted Thoracoscopic Lobectomy for Early-Stage Lung Cancer

Authors

Gustavo R. Rodriguez, Department of Surgery, The George Washington University Hospital, Washington, District of Columbia, USA.
John Kucera, Department of General Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Jared L. Antevil, Division of Cardiothoracic Surgery and Heart Center, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, USA.
Philip S. Mullenix, Division of Cardiothoracic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Gregory D. Trachiotis, Department of Surgery, The George Washington University Hospital, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

9-1-2024

Journal

Journal of laparoendoscopic & advanced surgical techniques. Part A

Volume

34

Issue

9

DOI

10.1089/lap.2024.0281

Keywords

VATS technique; lung cancer surgery; non-small cell lung cancer (NSCLC); sublobar resection; uniport VATS; video-assisted thoracoscopic surgery (VATS)

Abstract

The treatment of non-small cell lung cancer (NSCLC) has evolved tremendously in recent decades as innovations in medical therapies advanced concomitantly with minimally invasive surgical techniques. Despite early skepticism regarding its benefits, video-assisted thoracoscopic surgery (VATS) techniques for the surgical resection of early-stage NSCLC have now become the standard of care. After being the subject of many studies since its inception, VATS has been shown to cause less postoperative pain, have shorter recovery time, and have fewer overall complications when compared to conventional open approaches. Furthermore, some studies have shown it to have comparable oncological outcomes, though more higher evidence studies are needed. Newer technologies and improved surgical instruments, advancements in nodule localization techniques, and improved preoperative staging procedures have allowed for the development of newer, less invasive techniques such as uniportal VATS and parenchymal-sparing sublobar resections, which might further improve postoperative rates of complications in specific cases. These minimally invasive approaches have allowed surgeons to offer surgery to high-risk patients and those who would otherwise not tolerate conventional thoracotomy, though some relative contraindications still exist. This review aims to describe the evolution of VATS lobectomy, current techniques, its indications, contraindications, preoperative testing, benefits, and outcomes in patients with stage I and II NSCLC.

APA Citation

Rodriguez, Gustavo R.; Kucera, John; Antevil, Jared L.; Mullenix, Philip S.; and Trachiotis, Gregory D., "Contemporary Video-Assisted Thoracoscopic Lobectomy for Early-Stage Lung Cancer" (2024). GW Authored Works. Paper 5700.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5700

Department

Surgery