[Video-assisted thoracoscopic surgery lobectomy for lung carcinoma]

Video-assisted thoracoscopic surgery (VATS) has been utilized worldwide for the treatment of various types of thoracic disease, in particular for lung carcinoma. The following criteria are accepted as the operative indications for VATS lobectomy: i) clinical T1N1M0: ii) tumor located in the peripheral zone; and iii) non-small cell carcinoma. Videoscopic surgery has the merit of being less invasive, resulting in a low level of postoperative chest pain, short incisional scar, and short duration of hospital stay. Right-side upper mediastinal lymph node dissection is easy under the thoracoscope, although compared with standard thoracotomy it is not always possible to perform complete level II dissection on the left, because of the difficult approach to lymph nodess No. 3 and No. 4 under the aortic arch via the thoracoscope. The postoperative 5-year survival rate after VATS lobectomy is superior to that after standard thoracotomy. It is expected that the indications for VATS will be expanded to include T2 or N1 disease as thorascopic instruments and techniques improve.