Radical treatment for left upper-lobe cancer via complete VATS

Along with the development of video-assisted thoracic surgery (VATS), its role in radical treatment is basically the same as the conventional open surgery. Meanwhile, as a minimally invasive technique, it can achieve quick recovery. Nowadays the value of VATS has been globally recognized, and its indications have been further expanded. The common procedures of VATS lobectomy include anatomic lobectomy, single-direction lobectomy, simultaneous stapling, and retrograde lobectomy. Retrograde lobectomy is particularly useful for patients who are not feasible for anatomic lobectomy due to the swollen lymph nodes at the hilum of lung or because the tumors have invaded the pulmonary artery.

This article describes a 60-year-old female patient with left upper lobe carcinoma who underwent complete VATS retrograde lobectomy due to swollen lymph nodes at the hilum of lung. Chest CT indicated a shadow at the left upper pulmonary lobe, along with swollen lymph nodes at the hilum of lung. The mass invaded the first branch of the pulmonary artery. Retrograde lobectomy was then performed.

The postoperative recovery was good. Pathology showed an invasive adenocarcinoma at the left upper lung, along with lymph node metastases at the hilum of lung and mediastinum. No cancer was found at the bronchial stumps and vascular stumps.

Complete VATS retrograde lobectomy is safe and feasible for patients with swollen lymph nodes at the hilum of lung.