Original articleGeneral thoracicVideo-Assisted Thoracic Surgery Lobectomy: Experience With 1,100 Cases
Section snippets
Procedure
Under single-lung anesthesia, the VATS procedures were anatomic dissections with individual ligation of the vessels and bronchi. A 5-mm trocar for the 5-mm, 30-degree thoracoscope was placed through the eighth intercostal space in the midaxillary line. A 2-cm incision was made in the sixth intercostal space in the midclavicular line. A ring forceps through that incision displaced the lung posteriorly to expose the superior pulmonary vein. A utility incision was made directly lateral from the
Results
From February 1992 through December 2004, 1,100 patients underwent VATS with the intention to perform a minimally invasive anatomic pulmonary resection. They were 595 women (54.1%) and 505 men (45.9%). Mean age was 71.2 years (range, 16 to 94); 160 patients were aged 80 years or more.
The resections performed are seen in Table 1. The pathologic diagnoses for the 1,100 resections include the following: primary lung cancer (1,015 patients), benign diseases (53 patients, as seen in Table 2),
Comment
Published series of VATS lobectomy shows that the procedure is being performed around the world [2, 7, 8, 9, 10, 11, 12, 13, 14, 15]. However, less than 10% of lobectomies are currently performed with VATS, because most thoracic surgeons are still not comfortable with the technique. In the largest published experience with VATS lobectomy, we have shown that the procedure can be performed safely and with some apparent advantages over a thoracotomy. The length of stay is short and the rate of
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