Video-assisted thoracoscopic (VATS) lobectomy after induction therapy

Concerns regarding the sequelae of neoadjuvant chemotherapy or chemoradiotherapy on the pleural space and tissue planes had previously deterred the application of video-assisted thoracoscopic (VATS) lobectomy for patients who underwent neoadjuvant therapy. As experience with VATS has increased, however, its application toward more technically demanding operations has also expanded. The diminished impact on pulmonary function associated with the VATS approach may make pulmonary resection more tolerable in compromised patients. This article describes an approach designed for maximal safety on carefully selected patients who have undergone induction therapy.