Video-assisted thoracoscopic surgery lobectomy: The first Indian report

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Pulmonary Medicine

Background:

• Tuberculosis endemicity in India contributes to surgeon hesitancy in performing video-assisted thoracoscopic surgery (VATS) lobectomy due to concerns about pleural adhesions and lymph node involvement.
• This study addresses these concerns by reporting initial experiences with VATS lobectomy in an Indian cohort.

Purpose of the Study:

• To evaluate the feasibility and safety of performing VATS lobectomy using a standardized three-port anterior approach in an Indian population.
• To assess outcomes in both benign and malignant thoracic conditions.

Main Methods:

• A retrospective analysis of 102 VATS lobectomies performed between March 2012 and September 2016.
• All procedures utilized a standardized three-port anterior approach.
• Patient demographics, diagnoses (benign disease, lung cancer, pulmonary metastases), and operative details were recorded.

Main Results:

• The overall conversion rate was 8.82%.
• 80.4% of patients experienced no postoperative complications.
• Average blood loss was 211.37 ml, mean operative time was 173 minutes, with a median hospital stay of 5 days.
• No in-hospital or 30-day mortality was observed; prolonged air leak was the most common complication.

Conclusions:

• VATS lobectomy is a feasible and safe procedure for both benign and malignant thoracic conditions in India.
• The study demonstrates that fears regarding adhesions in the Indian context are largely unwarranted.
• Properly selected benign cases can be safely managed with VATS lobectomy.