Video-Assisted Thoracic Surgery Lobectomy for Lung Cancer in Ramathibodi Hospital

Montien Ngodngamthaweesuk MD*, Sukasom Attanawanich MD*, Narumol Kijjanon RN**

Affiliation : * Division of Thoracic Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Background : Although the public perceives video-assisted thoracic surgery (VATS) as advantageous because it is less invasive than a standard thoracotomy. There are questioned the safety of VATS lobectomy and its adequacy as a cancer operation. This study is reviewed to assess this issue. Material and Method: This retrospective study was performed between January 2009 and June 2011 in 58 patients who underwent VATS for a standard anatomic lobectomy with lymph node sampled or dissection for lung cancer 43 women (74%) and 15 men (26%) and mean age 60.2811.14 years. None of this study group had any pleural effusion or pleural dissemination.
Results : The most symptom and sign of patients with lung cancer were normal [48 cases (83%), 54 cases (93%) respectively]. The most risk factor was smoking [12 cases (20%)]. The most lobectomy of VATS lobectomy was right upper lobectomy [17 cases (29%)] and the longest duration of VATS lobectomy was left upper lobectomy was 237.0038.60 minutes. Thirty- one patients (53.4%) were adenocarcinoma. The VATS lobectomy was adequate for lung cancer surgery because malignant cells were not found from cytologic study of pleural lavages. The conversion rate from VATS to standard thoracotomy lobectomy was seven cases (12%), which the common causes were pleural symphysis and inadequate one lung ventilation. The postoperative courses showed minimal blood transfusion (0.110.37 ū), intensive care unit (ICU) stay (0.610.56 days) and intercostal drainage (ICD) duration (6.105.79 days). There were no intra-and post-operative death. Seven cases (12%) had many complications; the most complication was bacteria pneumonia. A case needed re-thoracotomy due to medical treatment failure for chylothorax.
Conclusion : VATS lobectomy (anatomic lobectomy and lymph nodes sampled or dissection) for lung cancer can be performed with low morbidity and no mortality.

Keywords : Video-assisted thoracic surgery (VATS), Lung cancer pleural lavage

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