[Technical evaluation of video-assisted lung resection for lung cancer]

There are two major problems including indications and techniques in video-assisted lung resection for lung cancer. The current technique of video-assisted lung resection have various troublesome procedures as compared with conventional open thoracic surgery. We have designed a new thoracoscopic instrument as a ligation device. Between September 1997 and August 1999, 15 patients with early lung cancer underwent video-assisted lobectomy (VAL). In 5 patients, VAL was performed through skin incisions of 3 cm using this new device and at extraction of the resected lung the skin incision was elongated minimally (Group A). In 10 patients, a skin incision of 6-8 cm was made enough to perform VAL without the new device at the beginning of the operation (Group B). Total length of skin incisions (TLS) and total postoperative pleural discharge (TPD) were measured. TLS was 7.2 +/- 1.47 cm in group A, 11.9 +/- 4.50 cm in group B (p = 0.029). TPD was 492 +/- 256 ml in group A, 1.132 +/- 591 ml in group B (p = 0.032). TPD might be thought as an index of invasion of VAL and it was difficult to decrease TPD significantly. The new device made it possible to feel the ligature tension when the device was in touch with the chest wall. In a result, the device improved technical procedure of VAL and contributed toward less invasive surgery.