[Video-assisted major pulmonary resections (lobectomies)].

Abstract

New applications of the video-assisted technique for the management of intrathoracic diseases continue to be developed, including major lung resections for cancer. The differences in the techniques proposed from various centers reflect the fact that the procedure is not accurately standardized yet and that prospective randomized trials with long-term follow-up data are needed. The authors report the results of their preliminary experience with a mini-invasive modern approach for video-assisted anatomic lobectomy: an utility muscle-sparing minithoracotomy through the auscultatory triangle. Eight patients successfully undergone this surgical procedure (7 for non-small cell lung cancer in early stage, 1 for benign disease). No mortality, nor complications (including minor morbidity: i.e. rib fractures) were recorded. Medium hospital stay time was 9.25 days (range 7-16) and chest drainage time 6 days (range 4-11). This operation proved to be technically feasible, although an accurate selection of patients and an adequate training in thoracoscopic procedures are mandatory. According to the more recent literature no significant differences are noted in operation's time, postoperative pain, chest drainage time, hospital stay compared to the standard posterolateral thoracotomy incisions. Otherwise the approach described enables to perform a truly "conservative" operation in conformity with the philosophy of the minimal invasive surgery and the patient's comfort and functional recover 2-3 weeks after surgery seems to be improved.