Video-assisted thoracoscopic surgery (VATS): left upper lobectomy and complete lymphadenectomy by fissureless anterior approach
Epublication WebSurg.com, Jan 2014;14(01). URL: http://websurg.com/doi/vd01en4126
The surgical management of non-small cell lung cancer (NSCLC) involves anatomical lung resection and systematic mediastinal lymph node dissection. Video-assisted thoracic surgery (VATS) lobectomy for early NSCLC is currently preferred over a thoracotomy in experienced centers. Possible advantages described of VATS lobectomy are decreased postoperative pain, less blood loss, shortened hospital stay, fewer overall complications, diminished immunologic suppression, as well as an increased ability to deliver adjuvant therapy. Oncological results are at least equivalent as thoracotomy in terms of long-term recurrence and survival rates. We present the case of a 58-year-old woman with suspicion of peripheral pulmonary cT1 cN0 cancer who initially underwent wedge resection by VATS of the lesion with preoperative localization using a CT-guided hook wire. Frozen section revealed the presence of squamous cell carcinoma, and completion lobectomy with complete mediastinal lymph node dissection was finally performed by VATS.