Assessment of node dissection for clinical stage I primary lung cancer by VATS

Watanabe, Atsushi; Koyanagi, Tetsuya; Obama, Takuro; Ohsawa, Hisayoshi; Mawatari, Tohru; Takahashi, Noriyuki; Ichimiya, Yasunori; Abe, Tomio
May 2005
European Journal of Cardio-Thoracic Surgery;May2005, Vol. 27 Issue 5, p745
Academic Journal
Abstract: Objective: The feasibility of systematic node dissection (SND) for stage I primary lung cancer by video-assisted thoracic surgery (VATS) remains controversial. The aim of this study was to assess the feasibility of SND by VATS. Methods: Four hundred and eleven patients with clinical stage I primary lung cancer were enrolled in this study. Two hundred and twenty-one patients, VATS group, underwent a major pulmonary resection with SND by VATS through a minithoracotomy (30–70mm) and two access ports; 190 patients, open thoracotomy (OT) group, did so through anterolateral thoracotomy. The two groups were compared regarding clinical data including number of dissected nodes in each nodal station for evaluating the feasibility of SND by VATS. Results: In the right side, the total number (N) of nodes dissected (VATS 31 vs OT 31, P=0.899), N of mediastinal nodes dissected (20 vs 21, P=0.553), and N of dissected nodes in each nodal station were similar between the two groups. In the left side, total N of nodes dissected (28 vs 27, P=0.714), N of mediastinal nodes dissected (16 vs 17, P=0.333), and N of dissected nodes in each nodal station were similar between the two groups. There were three (1.4%) and five (2.6%) operation related deaths in the VATS group and OT group, respectively (P=0.48). Chest tube duration was shorter in the VATS group than the OT group (5.8 vs 7.6 days, P=0.001). The incidences of chylothorax, recurrent laryngeal nerve injury and pleural effusion requiring thoracentesis after surgery were similar between the two groups (3 vs 4, P=0.709; 5 vs 3, P=0.480, 3 vs 8, P=0.122). The 5-year actuarial recurrence-free survival rate and cumulative survival rate of pathological stage IA cases were similar between the two groups (88.6 vs 92.4%, P=0.698; 92.9 vs 86.5%, P=0.358). Conclusions: The SND by VATS was as technically feasible as SND through OT regarding number of dissected nodes and morbidity. It seems acceptable as an oncological treatment for clinical stage I lung cancer.


Related Articles

  • Landmarks in Simple Pleural Effusions. Kaunitz, Julius // JAMA: Journal of the American Medical Association;6/18/2014, Vol. 311 Issue 23, p2444 

    The article discusses the radiographic diagnosis of pleural effusion. Topics discussed include the dry taps procedure performed on the patient, reason for the failure in thoracentesis in simple pleural effusion, three radiographic zones of pleural effusions for accurate selection of the site for...

  • Peritoneal and Pleural Ports for Management of Refractory Ascites and Pleural Effusions: Assessment of Impact on Patient Quality of Life and Hospice/Home Nursing Care. Monsky, Wayne L.; Yoneda, Ken Y.; MacMillan, John; Deutsch, Larry-Stuart; Dong, Paul; Hourigan, Helen; Schwartz, Yvonne; Magee, Stacey; Duffield, Curtis; Boak, Tammy; Cernilia, James // Journal of Palliative Medicine;Sep2009, Vol. 12 Issue 9, p811 

    Purpose: Patients with end-stage malignancies often have refractory ascites or pleural effusions requiring repeated paracenteses or thoracenteses. Subcutaneous peritoneal and pleural port catheters are an alternative therapeutic option. We evaluate the clinical utility of this approach and the...

  • Diffusion-weighted MR imaging of pleural fluid: differentiation of transudative vs exudative pleural effusions. Baysal, T.; Bulut, T.; Gökirmak, M.; Kalkan, S.; Dusak, A.; Dogan, M. // European Radiology;May2004, Vol. 14 Issue 5, p890 

    The aim of this study was to evaluate the ability of diffusion-weighted MRI in differentiating transudative from exudative pleural effusions. Fifty-seven patients with pleural effusion were studied. Diffusion-weighted imaging (DWI) was performed with an echo-planar imaging (EPI) sequence (b...

  • Malign plevral efüzyonlu olgularda randomize olarak VATS plörektomi ile küçük kalibrasyonlu kataterle talk plörodezis sonuçlarının karşılaÅŸtırılması. Meteroğlu, Fatih; Tunçözgür, Bülent // Journal of Clinical & Experimental Investigations / Klinik ve De;2012, Vol. 3 Issue 2, p223 

    Objectives: Pleural effusion occurs as a result of detoriation in equilibrium between absorption and secretion. We aimed to investigate the clinical responses of talk pleurodesis and pleurectomy with video assisted thoracoscopic surgery (VATS) in patients with malignant pleural effusion....

  • Management of Chylothorax in Children. Suddaby, Elizabeth C.; Schiller, Sue // Pediatric Nursing;Jul/Aug2004, Vol. 30 Issue 4, p290 

    Chylothorax is a collection of a white milky drainage from the lym-phatic system within the thoracic cavity that can impair respiratory status as it accumulates. Management of this uncommon complication of thoracic surgery can include: total parenteral nutrition (TPN), low-fat enteral nutrition,...

  • Does This Patient Have an Exudative Pleural Effusion? Wilcox, M. Elizabeth; Chong, Christopher A. K. Y.; Stanbrook, Matthew B.; Tricco, Andrea C.; Wong, Camilla; Straus, Sharon E. // JAMA: Journal of the American Medical Association;6/18/2014, Vol. 311 Issue 23, p2422 

    IMPORTANCE Thoracentesis is performed to identify the cause of a pleural effusion. Although generally safe, thoracentesis may be complicated by transient hypoxemia, bleeding, patient discomfort, reexpansion pulmonary edema, and pneumothorax. OBJECTIVE To identify the best means for...

  • Ultrasound-guided thoracenthesis: the V-point as a site for optimal drainage positioning. ZANFORLIN, A.; GAVELLI, G.; OBOLDI, D.; GALLETTI, S. // European Review for Medical & Pharmacological Sciences;Jan2013, Vol. 17 Issue 1, p25 

    INTRODUCTION: In the latest years the use of lung ultrasound is increasing in the evaluation of pleural effusions, because it makes follow-up easier and drainage more efficient by providing guidance on the most appropriate sampling site. However, no standardized approach for ultrasound-guided...

  • VALIDATION OF A METHOD FOR CONTINUOUS PLEURAL MANOMETRY. Salamonsen, Matthew; Ware, Robert; Fielding, David // Turkish Respiratory Journal / Solunum Dergisi;2013 Supplement, Vol. 15, p4 

    Aim: Pleural manometry can predict the presence of trapped lung and guide large-volume thoracentesis. The current technique for pleural manometry transduces pressure from the needle or tube to the outside of the chest, necessitating intermittent cessation of fluid drainage at times of pressure...

  • Benefits of minocycline and rifampin-impregnated central venous catheters. Leon, Cristóbal; Ruiz-Santana, Sergio; Rello, Jordi; de Ia Torre, Maria V.; Vallés, Jordi; Álvarez-Lerma, Francisco; Sierra, Rafael; Saavedra, Pedro; Álvarez-Salgado, Francisco // Intensive Care Medicine;Oct2004, Vol. 30 Issue 10, p1891 

    Objective: To determine the efficacy of minocycline and rifampin-impregnated catheters compared to non-impregnated catheters in critically ill patients. Design: Prospective, randomized, double-blind, controlled, multicenter trial. Setting: Intensive care units of seven acute-care teaching...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics