Our Summary

This research paper discusses a type of minimally invasive surgery called video-assisted thoracic surgery (VATS) lobectomy. This procedure is commonly used to treat patients with early-stage non-small cell lung cancer. In this operation, the surgeon doesn’t use a rib spreader and only views the surgery through a video monitor.

The authors of this study perform this surgery through 5 small incisions or ‘ports’, as it provides a good view of the operating area. They use this technique not only for early-stage lung cancer but also for more advanced stages.

The research found that the survival rate after 5 years for patients with advanced cancer was 59%, and the rate of patients who didn’t experience a recurrence of their cancer was 34% after 5 years. These results were based on a median follow-up period of 54 months.

Some experienced medical centers are now using VATS for more complicated procedures, such as removing the entire lung, removing a lobe of the lung, removing part of the chest wall and reconstructing the lung’s main artery. However, the authors of this paper have not yet used VATS for these more complex surgeries, since it’s not yet clear whether VATS is better than traditional surgery in terms of invasiveness and effectiveness in treating cancer.

FAQs

  1. What is video-assisted thoracic surgery (VATS) lobectomy and who is it suitable for?
  2. Are there any limitations to the use of VATS lobectomy for lung cancer patients?
  3. How does the survival rate compare for patients who have undergone VATS lobectomy for N2 disease?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and participating in rehabilitation programs to help with recovery and improve lung function. It is also important to avoid smoking and exposure to secondhand smoke to promote healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for lung surgery include those with early-stage non-small cell lung cancer, as well as those with N1-2 disease. Additionally, patients with complex procedures such as pneumonectomy, sleeve lobectomy, en bloc chest wall resection, and reconstruction of the pulmonary artery may also be recommended for lung surgery. It is important to consider the degree of surgical invasiveness and oncological efficacy when determining whether VATS or thoracotomy is the preferred approach for each individual patient.

Timeline

Before lung surgery:

  1. Diagnosis: The patient undergoes various tests and screenings to determine the need for lung surgery, such as imaging scans, biopsies, and pulmonary function tests.
  2. Pre-operative preparation: The patient receives instructions on how to prepare for surgery, which may include fasting before the procedure, stopping certain medications, and undergoing additional tests.
  3. Consultation: The patient meets with the surgical team to discuss the procedure, potential risks and benefits, and what to expect during the recovery period.

After lung surgery:

  1. Immediate post-operative care: The patient is closely monitored in the recovery room for any complications, such as bleeding, infection, or breathing difficulties.
  2. Hospital stay: The patient typically stays in the hospital for a few days to a week following surgery, depending on the extent of the procedure and how well they are recovering.
  3. Rehabilitation: The patient may undergo physical therapy and breathing exercises to help improve lung function and overall recovery.
  4. Follow-up appointments: The patient will have regular follow-up appointments with their healthcare team to monitor their progress, discuss any ongoing symptoms or concerns, and review the results of any post-operative tests.
  5. Long-term recovery: The patient may experience some limitations in their daily activities and may need to make lifestyle changes to support their lung health. It may take several weeks to months for the patient to fully recover and return to their normal routine.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the lung surgery procedure?
  2. How long will the recovery process take, and what can I expect in terms of pain management and rehabilitation?
  3. Will I need any additional treatments or therapies after the surgery, such as chemotherapy or radiation?
  4. How experienced are you in performing VATS lobectomy procedures, and what is your success rate with this technique?
  5. Are there any specific criteria or tests that need to be met before undergoing lung surgery?
  6. What is the expected outcome in terms of prognosis and quality of life post-surgery?
  7. How long will I need to stay in the hospital after the surgery, and what kind of follow-up care will be required?
  8. Are there any lifestyle changes or precautions I need to take after the surgery to ensure optimal recovery and long-term health?
  9. Can you provide me with information on support groups or resources for patients who have undergone lung surgery?
  10. Are there any alternative treatment options or clinical trials available that I should consider before proceeding with surgery?

Reference

Authors: Tsubochi H. Journal: Kyobu Geka. 2016 Jul;69(8):655-60. PMID: 27440028