Complete Thoracoscopic Lobectomy: A new era at the ‘‘G. Papanikolaou’’ Hospital

Abstract

SUMM ARY. Twenty years after the first announcement of itsapplication, thoracoscopic lobectomy has become the gold standardfor the treatment of early stage lung cancer in many large medicalcentres in other countries. This method appears to offer fasterrecovery and a lower rate of complications than the conventionalopen technique, but many thoracic surgeons, including those in theGreek national health care system, continue to argue against theeffectiveness of the method in the management of primary lungcancer. Material and Methods Between March 2009 and October2012, 17 patients with peripheral lung tumours and unrevealingbronchoscopy underwent fully thoracoscopic lobectomy. All theoperations were performed under general anaesthesia, with one-lungventilation and without the use of a rib spreader, through the creationof 3-4 ports in the ipsilateral hemithorax. Lymph node dissectionor sampling was carried out in all patients, after completion of thelobectomy. Results Specifically 4 right upper, 1 middle, 2 lowerright, 6 left upper and 4 left lower thoracoscopic lobectomies wereperformed. The mean duration of operation was 3 hours and themean duration of hospital stay was 4 days. Conclusion Thoracoscopiclobectomy is a safe, and minimally traumatic procedure that offersfaster recovery compared with the open method. The oncologicalresults are comparable to those of the open thoracotomy technique,provided that the intraoperative principles of radical resection andlymphadenectomy are maintained. Pneumon 2013, 26(2):157-161