[Complete thoracoscopic lobectomy with systematic nodal dissection via 5 ports for lung cancer]

We herein report a procedure for thoracoscopic lobectomy with mediastinal dissection for primary lung cancer using 5 access ports. A thoracoscope is inserted through an access port on the mid-axillary line in the 6th intercostal space. The availability of 4 instruments through 4 ports makes it easy to divide bronchus and pulmonary vessels and to dissect mediastinal lymph nodes. Between April 2005 and March 2007, 88 patients with clinical stage I/II primary lung cancer underwent this thoracoscopic procedure. Mean (+/- SD) operation time was 148 +/- 42 minutes and mean (+/- SD) blood loss was 166 +/- 148 ml. No local recurrence was found in patients with pathologic stage I/II diseases, whereas ipsilateral mediastinal lymphadenopathy occurred in 2 with pathologic stage III A disease during the mean post-opetrative period of 518 +/- 200 days. The thoracoscopic surgery for lung cancer presented here was seen to be a feasible procedure and has the advantage of reducing operative time.