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Supplement: 2nd International Bi-Annual Minimally Invasive Thoracic Surgery Summit

Video-Assisted Thoracic Surgery Lobectomy: Single Institutional Experience With 704 Cases

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

^_* Address correspondence to Dr K. Kim, Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, 50 Ilwon-dong, Gangnam-gu, Seoul, 135–710, Korea (Email: kmkim0070{at}skku.edu).

Presented at the 2^nd International Bi-Annual Minimally Invasive Thoracic Surgery Summit, Boston, MA, October 9–10, 2009.

Background: During the past decade, video-assisted thoracic surgery (VATS) lobectomy has been performed with increasing frequency in patients with early-stage non–small cell lung cancer (NSCLC). However, questions remain as to whether VATS lobectomy reduces local recurrence and improves long-term survival in patients with NSCLC.

Methods: We retrospectively reviewed short-term and midterm outcomes, including postoperative morbidity, mortality, recurrence rate, and survival, in patients undergoing VATS lobectomy.

Results: Between 2003 and 2008, 704 patients underwent VATS lobectomy for the following indications: NSCLC (n = 548), carcinoid tumors (n = 7), pulmonary metastases (n = 22), and benign diseases (n = 127). One hundred eleven of 548 clinical stage I NSCLC patients (20.3%) experienced pathologic upstaging postoperatively. There were 9 in-hospital deaths (1.3%); all of these patients died of acute respiratory distress syndrome. Sixty-four patients experienced postoperative complications (9.1%). The median follow-up was 20 months for patients with NSCLC. During follow-up, 54 patients had a recurrence, and 13 patients died. Disease-free survival for patients with pathologic stage I disease was 92.7% at 1 year and 87.6% at 3 years. For patients with pathologic N1 (n = 55) and N2 diseases (n = 41), disease-free survival at 3 years was 79.3% and 57.1%, respectively.

Conclusions: Video-assisted thoracoscopic surgery lobectomy is a technically feasible and safe operation with excellent survival for early-stage lung cancer. For patients with pathologic N1 or N2 diseases after VATS lobectomy, survival was not compromised by this minimally invasive approach.

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