IS VIDEO-ASSISTED THORACOSCOPIC SURGERY SUITABLE FOR RESECTION OF PRIMARY LUNG-CANCER

We investigated the validity of thoracoscopic surgery in patients with primary lung cancer undergoing lobectomy. 14 primary lung cancer pati ents treated by typical VATS lobectomy and one by anatomical segmentec tomy, were compared with 56 patients with Stage-I lung cancer undergoi ng standard lobectomy (control group), the results focusing on the lym ph-nodes dissected. All 14 lobectomy patients showed primary lesions o f size less than 3 cm. Following classification of the lymph-nodes int o groups I (hilar lymph node) and II (mediastinal lymph node), we comp ared results according to the sites of the lobectomies conducted. Numb ers of dissected lymph-nodes were similar in patients whether undergoi ng standard thoracotomy or VATS lobectomy. We also investigated what h istological types of cancer should be treated by VATS lobectomy by com paring preoperative and operative staging in the control group. The re sults showed that in most patients with squamous-cell carcinoma judged as T1 NO MO the staging corresponded, the other patients actually bei ng in N1 (Stage II). Of Patients with adenocarcinoma of T1 NO MO, howe ver, 14% had lymph-node metastasis even into the superior mediastinum, i.e., Stage III. The overall findings suggest at present that VATS lo bectomy should be applied preferably to patients with a histological t yping such as squamous cell carcinoma or alveolar cell carcinoma of re latively early stage, i.e. preoperative Stage I.