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Thoracoscopic major lung resections: an Asian perspective

A P Yim¹, M B Izzat, H P Liu

¹Department of Surgery, Prince of Wales Hospital, Hong Kong.

Seminars in Thoracic and Cardiovascular Surgery

|November 4, 1998

Summary

Video-assisted thoracic surgery (VATS) is a feasible option for major lung resections in carefully selected patients. This approach demonstrates favorable outcomes and complication rates comparable to traditional open surgery.

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Area of Science:

Thoracic Surgery
Minimally Invasive Surgery
Surgical Oncology

Background:

The use of video-assisted thoracic surgery (VATS) for extensive lung resections remains a subject of debate.
Limited data exists on the combined experience of VATS major resections from multiple Asian centers.

Purpose of the Study:

To evaluate the feasibility and intermediate-term outcomes of VATS for major lung resections.
To assess the safety and efficacy of VATS compared to open procedures.

Main Methods:

A retrospective review of 214 patients who underwent VATS major lung resections (lobectomies, segmentectomies, bilobectomies, pneumonectomies) across three Asian centers from 1993 to 1997.
Patients were selected based on stringent criteria.
Specific surgical techniques included avoiding rib spreading, using conventional instruments, and employing wound protectors for specimen retrieval.

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Main Results:

The study included 214 VATS major lung resections, predominantly for primary lung cancer.
One postoperative surgical death and 47 non-fatal complications were recorded, showing favorable comparison with open surgery series.
Among patients with primary lung cancer, 93% survived after a mean follow-up of 26 months.

Conclusions:

VATS major lung resection is technically achievable in selected patient populations.
The VATS approach for major lung resection is associated with favorable intermediate-term results and acceptable complication rates.