[Evaluation of thoracoscopic surgery with mini-thoracotomy for primary lung cancer--as seen from the angle of lymph...

The extent of thoracoscopic surgery using a mini-thoracotomy for radical lung cancer surgery was investigated with regard to practical applicability. Thirteen patients with lung cancer underwent video-assisted lobectomy or segmentectomy and lymph node dissection through a 6-8 cm mini-thoracotomy. Eleven of thirteen cases were able to undergo video-assisted lobectomy and segmentectomy, but in one patient with strong adhesion and one patient who developed hemorrhage due to pulmonary arterial injury, thoracotomy was extended to 15-20 cm. Ten patients with lung cancer who underwent lobectomy under standard thoracotomy, underwent lymph node dissection under simulated 6-8 cm mini-thoracotomy. These ten cases and five cases who underwent lymph node dissection under 6-8 cm mini-thoracotomy were then switched over to standard thoracotomy to examine the possibility of residual lymph nodes. On the right-side, R2 lymph node dissection was practical, but on the left-side, #3, 3p, 4, 7 lymph node dissections were insufficient or impractical in some cases. The above results suggested that right-sided lobectomy is practical for radical thoracoscopic surgery with a mini-thoracotomy is practical for up to stage II. However, on the left side, the procedure should be confined to stage I.