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New Technology

Microthoracoscopic One-Port Method for Lung Cancer

Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan

Accepted for publication September 30, 2008.

^_* Address correspondence to Dr Iwazaki, Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 2591193, Japan (Email: iwasaki{at}is.icc.u-tokai.ac.jp).

Purpose: We investigated whether the one-window method for thoracoscopic operations is possible as an operation for early-stage lung cancer.

Description: The subjects were the 40 patients in whom ND2 lymph node dissection was performed among those with a preoperative diagnosis of stage IA (T1 N0 M0) lung cancer who underwent thoracoscopic operations in our hospital during the 2-year period from January 2001 to December 2002. With the patient in the lateral position, a Thoraco Holder (Fuji Systems Corp, Tokyo, Japan) was inserted between the fourth and fifth intercostal space on the anterior axillary line. The surgeon used it as a port for performing the surgical maneuvers. An access needle was placed in the auscultatory triangle in the fifth intercostal space, and a 3-mm thoracoscope was used. Pulmonary lobectomy and mediastinal dissection were performed in the same manner as the standard thoracoscopic two-windows method.

Evaluation: The one-window technique was successful in 38 patients, and conversion to the two-windows method occurred in the other 2. Mean operation time was 2 hours 18 minutes. A mean number of 16.5 lymph nodes were removed, and mean blood loss was 22 mL. All 40 patients are alive and free of recurrence at 5 or more years since the operation.

Conclusions: As a result of mastering the operation and developing improved instruments, pulmonary lobectomies can now be performed by the one-window method. This method is the least invasive method of pulmonary cancer surgery available at the present time.

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