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Video-assisted thoracic surgery major pulmonary resection requiring control of the main pulmonary artery

Department of Thoracic Surgery, Shin-Kokura Hospital, Federation of National Public Service Personnel Mutual Aid Associations, 1-3-1 Kanada, Kokurakita-ku, Kitakyusyu 803-8505, Japan

*Corresponding author. Tel.: +81-93-571-1031; fax: +81-93-591-0553.

E-mail address: ryoichi{at}med.uoeh-u.ac.jp (R. Nakanishi).

The purpose of this study is to examine the feasibility and safety of thoracoscopic major pulmonary resection requiring the cross-clamping of the main pulmonary artery (PA), in comparison to an open thoracotomy performed in patients with lung cancer. A retrospective database of 27 consecutive lung cancer patients, who underwent either video-assisted thoracic surgery (VATS) (n=13) or open thoracotomy (n=14) for a major pulmonary resection using these procedures, was analyzed regarding the demographic, perioperative, histopathologic, and outcome variables. The thoracoscopic procedures were successfully performed in 12 of 13 patients (92.3%). Two groups showed no differences in the demographic, perioperative, histopathologic and staging variables. Both groups presented with no mortality. The VATS group showed better results regarding the length of epidural anesthesia (P=0.0066), additional analgesic requirements (P=0.0009), and morbidity (P=0.0213) than the open thoracotomy group. Despite the short follow-up time, the two groups were comparable regarding both the recurrence and survival rates. The results indicate that VATS is feasible and safe for selected lung cancer patients requiring the cross-clamping of the main PA, with acceptable perioperative results in comparison to an open thoracotomy.

Key Words: Lung cancer; Pulmonary artery; Complications; Lobectomy; Pneumonectomy; Video-assisted thoracic surgery (VATS)