Thoracoscopic Pneumonectomy for Non-Small Cell Lung Cancer (NSCLC): A Case Report and Review of the Literature

Abstract

Minimally invasive resection of lung cancer remains surprisingly uncommon in comparison to the adoption of similar techniques in other surgical disciplines. The reported use of video-assisted thoracic surgery (VATS) lobectomy for anatomic resections in comparison to open lobectomy ranges from 10% -40% even though it has been demonstrated to be equivalent in safety and accomplishes the same oncologic goals. Further, it may provide improved survival outcomes as others have reported benefits in perioperative recovery and patient satisfaction. VATS pneumonectomy has been far less commonly described despite the physiologic advantages such as less blood loss, shorter intensive care stay, and less respiratory compromise. This report specifically addresses this lacuna by drawing upon the successful case of a VATS pneumonectomy with fissure invasion and then considering why minimally invasive VATS techniques remain underutilized. In conclusion, we suggest that focused thoracic surgery fellowship training in VATS techniques will make thoracoscopic surgery a more conventional technique rather than a challenging procedure.

Share and Cite:

O. Andacoglu and J. Maloney, "Thoracoscopic Pneumonectomy for Non-Small Cell Lung Cancer (NSCLC): A Case Report and Review of the Literature," International Journal of Clinical Medicine, Vol. 4 No. 6A, 2013, pp. 23-27. doi: 10.4236/ijcm.2013.46A005.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] R. K. Sahai, C. E. Nwogu, S. Yendamuri, W. Tan, G. E. Wilding and T. L. Demmy, “Is Thoracoscopic Pneumonectomy Safe?” The Annals of Thoracic Surgery, Vol. 88, No. 4, 2009, pp. 1086-1092. doi:10.1016/j.athoracsur.2009.05.065
[2] McKenna, R. J. Jr., “Surgical Management of Primary Lung Cancer,” Seminars in Oncology, Vol. 34, No. 3, 2007, pp. 250-255. doi:10.1053/j.seminoncol.2007.03.006
[3] H. I. Libshitz, R. J. McKenna Jr. and C. F. Mountain, “Patterns of Mediastinal Metastases in Bronchogenic Carcinoma,” Chest, Vol. 90, No. 2, 1986, pp. 229-232. doi:10.1378/chest.90.2.229
[4] S. J. Swanson, B. F. Meyers, C. L. Gunnarsson, M. Moore, J. A. Howington, M. A. Maddaus, R. J. McKenna and D. L. Miller, “Video-Assisted Thoracoscopic Lobectomy Is Less Costly and Morbid than Open Lobectomy: A Retrospective Multiinstitutional Database Analysis,” The Annals of Thoracic Surgery, Vol. 93, No. 4, 2012, pp. 10271032. doi:10.1016/j.athoracsur.2011.06.007
[5] A. Mahtabifard, C. B. Fuller and R. J. McKenna Jr., “Video-Assisted Thoracic Surgery Sleeve Lobectomy: A Case Series,” The Annals of Thoracic Surgery, Vol. 85, No. 2, 2008, pp. S729-S732. doi:10.1016/j.athoracsur.2007.12.001
[6] D. G. Nicastri, J. P. Wisnivesky, V. R. Litle, J. Yun, C. Chin, F. R. Dembitzer and S. J. Swanson, “Thoracoscopic Lobectomy: Report on Safety, Discharge Independence, Pain, and Chemotherapy Tolerance,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 135, No. 3, 2008, pp. 642-647. doi:10.1016/j.jtcvs.2007.09.014
[7] W. S. Walker, M. Co-dispoti, S. Y. Soon, S. Stamenkovic, F. Carnochan and G. Pugh, “Long-Term Outcomes Following VATS Lobectomy for Non-Small Cell Bronchogenic Carcinoma,” European Journal Cardio-Thoracic Surgery, Vol. 23, No. 3, 2003, pp. 397-402. doi:10.1016/s1010-7940(02)00814-x
[8] K. Yamamoto, A. Ohsumi, F. Kojima, N. Imanishi, K. Matsuoka, M. Ueda and Y. Miyamoto, “Long-Term Survival after Video-Assisted Thoracic Surgery Lobectomy for Primary Lung Cancer,” The Annals of Thoracic Surgery, Vol. 89, No. 2, 2010, pp. 353-359. doi:10.1016/j.athoracsur.2009.10.034
[9] M. W. Onaitis, R. P. Petersen, S. S. Balderson, E. Toloza, W. R. Burfeind, D. H. Harpole Jr. and T. A. D’Amico, “Thoracoscopic Lobectomy Is a Safe and Versatile Procedure: Experience with 500 Consecutive Patients,” Annals of Surgery, Vol. 244, No. 3, 2006, pp. 420-425.
[10] R. J. McKenna Jr. and W. V. Houck, “New Ap-proaches to the Minimally Invasive Treatment of Lung Cancer,” Current Opinion in Pulmonary Medicine, Vol. 11, No. 4, 2005, pp. 282-286. doi:10.1097/01.mcp.0000166589.08880.44
[11] M. S. Allen, G. E. Darling, T. T. Pechet, J. D. Mitchell, J. E. Herndon 2nd, R. J. Landreneau, R. I. Inculet, D. R. Jones, B. F. Meyers, D. H. Harpole, J. B. Putnam Jr. and V. W. Rusch, “ACOSOG Z0030 Study Group. Morbidity and Mortality of Major Pulmonary Resections in Patients with Early-Stage Lung Cancer: Initial Results of the Randomized, Prospective ACOSOG Z0030 Tri-al,” The Annals of Thoracic Surgery, Vol. 81, No. 3, 2006, pp. 1013-1019. doi:10.1016/j.athoracsur.2005.06.066
[12] H. Wada, T. Nakamura, K. Nakamoto, M. Maeda and Y. Watanabe, “Thirty-day Operative Mortality for Thoracotomy in Lung Cancer,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 115, No. 1, 1998, pp. 70-73. doi:10.1016/S0022-5223(98)70444-1
[13] G. A. Silvestri, J. Handy, D. Lackland, E. Corley and C. E. Reed, “Specialists Achieve Better Outcomes than Generalists for Lung Cancer Surgery,” Chest, Vol. 114, No. 3, 1998, pp. 675-680. doi:10.1378/chest.114.3.675
[14] B. A. Whitson, S. S. Groth, S. J. Duval, S. J. Swanson and M. A. Maddaus, “Surgery for Early-Stage Non-Small Cell Lung Cancer: A Systematic Review of the VideoAssisted Thoracoscopic Surgery versus Tho-racotomy Approaches to Lobectomy,” The Annals of Thoracic Surgery, Vol. 86, No. 6, 2008, pp. 2008-2016. doi:10.1016/j.athoracsur.2008.07.009
[15] C. E. Nwogu, S. Yendamuri and T. L. Demmy, “Does Thoracoscopic Pneumo-nectomy for Lung Cancer Affect Survival?” The Annals of Thoracic Surgery, Vol. 89, No. 6, 2010, pp. S2102-S2016. doi:10.1016/j.athoracsur.2010.03.019
[16] T. D. Yan, D. Black, P. G. Bannon and B. C. McCaughan, “Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials on Safety and Efficacy of Video-Assisted Thoracic Surgery Lo-bectomy for EarlyStage Non-Small-Cell Lung Cancer,” Journal of Clinical Oncology, Vol. 27, No. 15, 2009, pp. 2553-2562. doi:10.1200/JCO.2008.18.2733
[17] K. Sugi, M. Sudoh, K. Hirazawa, E. Matsuda and Y. Kaneda, “Intrathoracic Bleeding during Video-Assisted Thoracoscopic Lobectomy and Seg-mentectomy,” Kyobu Geka, Vol. 56, No. 11, 2003, pp. 928-931.
[18] T. Ohtsuka, H. Nomori, H. Horio, T. Naruke and K. Suemasu, “Is Major Pulmonary Resection by Vid-eo-Assisted Thoracic Surgery an Adequate Procedure in Clinical Stage I Lung Cancer?” Chest, Vol. 125, No. 5, 2004, pp. 1742-1746. doi:10.1378/chest.125.5.1742
[19] C. E. Nwogu, M. Glinianski and T. L. Demmy, “Minimally Invasive Pneu-monectomy,” The Annals of Thoracic Surgery, Vol. 82, No. 1, 2006, pp. e3-e4. doi:10.1016/j.athoracsur.2006.04.054
[20] M. Sagawa, M. Sato, A. Sakurada, Y. Matsumura, C. Endo, M. Handa and T. Kondo, “A Prospective Trial of Systematic Nodal Dissection for Lung Cancer by VideoAssisted Thoracic Surgery: Can It Be Perfect?” The Annals of Thoracic Surgery, Vol. 73, No. 3, 2002, pp. 900904. doi:10.1016/S0003-4975(01)03409-9
[21] A. A. Conlan and A. Sandor, “Total Thoracoscopic Pneumonectomy: Indications and Technical Considerations,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 6, 2003, pp. 2083-2085. doi:10.1016/S0022-5223(03)01227-3
[22] M. Riquet, P. Berna, A. Arame, P. Mordant, J. C. Das Neves Pereira, C. Foucault, A. Dujon and F. Le Pimpec Barthes, “Lung Cancer Invading the Fissure to the Adjacent Lobe: More a Question of Spreading Mode than a Staging Problem,” European Journal Car-dio-Thoracic Surgery, Vol. 41, No. 5, 2012, pp. 1047-1051. doi:10.1093/ejcts/ezr143
[23] D. J. Boffa, S. Gangadharan, M. Kent, F. Kerendi, M. Onaitis, E. Verrier and E. Roselli, “Self-Perceived VideoAssisted Thoracic Surgery Lobectomy Proficiency by Recent Graduates of North American Thoracic Residencies,” Interactive CardioVasc Thoracic Surgery, Vol. 14, No. 6, 2012, pp. 797-800. doi:10.1093/icvts/ivr098
[24] S. R. Craig, M. Hamzah and W. S. Walker, “Video-Assisted Tho-racoscopic Pneumonectomy for Bronchial Carcinoid Tumor in a 14-Year-Old Girl,” Journal of Pediatric Surgery, Vol. 31, No. 12, 1996, pp. 1724-1726. doi:10.1016/S0022-3468(96)90063-9
[25] R. Nakanishi, A. Hirai, T. Yamashita and S. Oka, “VideoAssisted Thoracoscopic Completion Pneumonectomy for a Second Primary Cancer: A Case Report,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 135, No. 4, 2008, pp. 945-946. doi:10.1016/j.jtcvs.2007.11.043
[26] D. M. Anselmo, I. A. Perez and D. B. Shaul, “Thoracoscopic Pneumonectomy for Severe Bronchiectasis in a 9-Year-Old Female,” Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 18, No. 5, 2008, pp. 775-777. doi:10.1089/lap.2007.0214
[27] F. J. Podbielski, G. D. Marquez, D. G. Nelson, N. A. Diettrich and M. M. Connolly, “Thoracoscopic Assisted Pneumonectomy,” JSLS, Vol. 1, No. 1, 1997, pp. 75-77.
[28] S. R. Craig and W. S. Walker, “Initial Experience of Video assisted Thoracoscopic Pneumonectomy,” Thorax, Vol. 50, No. 4, 1995, pp. 392-5doi:10.1136/thx.50.4.392
[29] D Gonzalez-Rivas, M de la Torre, R Fernandez, J Garcia, “Single-Incision Video-Assisted Thoracoscopic Right Pneumonectomy,” Surgical Endoscopy, Vol. 11, 2012, pp. 26-29.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.