Video-Assisted Thoracic Surgery Efficacy in Systemic Nodal Dissection: A Single Institution Experience

Alessandro Baisi, Federico Raveglia, Matilde De Simone and Ugo Cioffi

Department of Thoracic Surgery, Azienda Ospedaliera San Paolo, University of Milan, Italy
Department of Surgery, University of Milan, Italy

^*Correspondance to: Alessandro Baisi 

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Abstract:

Background: According to the European Society of Thoracic Surgeons (ESTS) guidelines, systemic nodal dissection (SND) is mandatory in pulmonary resection for non-small cell lung cancer (NSCLC). Since VATS SND efficacy is still an uncertain issue, this is a key topic to definitively state the oncologic effectiveness of thoracoscopy. Our study compared the number of nodes and stations dissected and cN0-pN2 cases in VATS versus open thoracotomy. Material and
Methods: From June 2013 to December 2014, 30 patients with clinical stage I (T1- 2aN0M0) lung cancer underwent lobectomy at our thoracic surgery department. Clinical staging was always obtained by positron emission tomography (PET). All mediastinal nodes suspected were studied by ultrasound-guided bronchoscopy with fine needle aspiration (EBUS-FNA). Patients were referred to VATS or open thoracotomy based on clinical general conditions and tumor characteristics. SND was performed in both the groups.
Results: Among 30 patients who underwent lobectomy, 21 underwent open thoracotomy and 9 VATS. Four (13.3%) showed to have pN2 at definitive pathologic examination: 2 in VATS and 2 in open thoracotomy group. Mean operation time was longer in VATS than in open thoracotomy (p=0.03).There was not significant difference between the two groups in terms of total nodes dissected (p >0.05), mediastinal nodes dissected (p >0.05) and stations removed (p >0.05).
Conclusion: VATS SND is theoretically successful as open thoracotomy but it is technically more demanding and more time-consuming.

Keywords:

Vats; Lymphnode dissection; Non-small-cell lung cancer; Thoracotomy; Lymphnode staging

Cite the Article:

Baisi A, Raveglia F, De Simone M, Cioffi U. Video-Assisted Thoracic Surgery Efficacy in Systemic Nodal Dissection: A Single Institution Experience. Clin Oncol. 2016; 1: 1087.