Thoracoscopic surgery for lung cancer using the two small skin incisional method. Two windows method

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Stage I lung cancer necessitates surgical intervention, typically pulmonary lobectomy with mediastinal lymph node dissection.
• Conventional thoracoscopy presents limitations in visualization and accuracy for complex procedures like mediastinal lymph node dissection.

Purpose of the Study:

• To evaluate the efficacy and safety of the two-windows thoracoscopic method for pulmonary lobectomy and mediastinal lymph node dissection in Stage I lung cancer.
• To compare the outcomes of the two-windows method with standard thoracotomy.

Main Methods:

• Pulmonary lobectomy and mediastinal lymph node dissection were performed on 25 Stage I lung cancer patients using the two-windows thoracoscopic technique.
• The method involves posterior and lateral skin incisions for direct vision and thoracoscope insertion, allowing for improved operative field visualization.

Main Results:

• The mean operative time was 2 hours 15 minutes, with a mean blood loss of 82.6 ml.
• An average of 32 mediastinal lymph nodes were dissected, with a hospitalization range of 5-17 days.
• Patients experienced uneventful recovery, with no requirement for analgesics by postoperative day 6.

Conclusions:

• The two-windows method enhances visualization and accuracy in pulmonary lobectomy and mediastinal lymph node dissection, overcoming limitations of conventional thoracoscopy.
• This technique offers advantages including improved cosmesis, preserved respiratory function, reduced postoperative pain, decreased blood loss, and shorter operative times.
• The two-windows thoracoscopic approach is deemed equal or superior to standard thoracotomy for Stage I lung cancer and should be considered a standard surgical technique.