Thoracoscopic lobectomy for stage I non-small cell lung cancer

Lobectomy via video-assisted thoracoscopic surgery (VATS) has a lower rate of morbidity and is less immunosuppressive than open lobectomy. Compared with open lobectomy, VATS lobectomy appears to have equivalent oncological results. We review the literature on perioperative outcomes, biological impact, and oncological results. Most published reports to date--although retrospective--suggest significant perioperative advantages to VATS lobectomy over open lobectomy. Data on acute phase reactants and cellular immunity show that VATS lobectomy causes less of an inflammatory response and is less immunosuppressive than open lobectomy. Mid- to long-term oncological results of patients with early-stage non-small cell lung cancer (NSCLC) appear to be equivalent for VATS and open lobectomy. Clinical evidence indicates that VATS lobectomy for early-stage NSCLC is associated with fewer postoperative complications and less negative biological impact than open lobectomy. Furthermore, all data to date strongly suggest oncological equivalence between VATS and open lobectomy for patients with early-stage NSCLC.