Routine surgical videothoracoscopy as the first step of the planned resection for lung cancer

Contardo Vergani, Federico Varoli, Luca Despini, Sergio Harari, Enrico Mozzi, GianCarlo Roviaro

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: Notwithstanding preoperative staging, a number of procedures still end in an exploratory thoracotomy as a result of unexpected findings. The aim of this work is to evaluate the validity of routine videothoracoscopy, performed as the first step of every planned resection for non-small cell lung cancer, to assess tumor resectability and feasibility of the resection through thoracoscopy. Methods and Results: From November 1991 to December 2007, in our department, 1306 patients with non-small cell lung cancer, judged operable at conventional staging, underwent videothoracoscopy before the operation. Thoracoscopy revealed inoperability in 58 (4.4%) patients, mostly owing to pleural dissemination (2.5%) or mediastinal infiltration (1.7%). In the remaining 1248 (95.6%), thoracoscopy did not reveal inoperability. Of these, 449 (34.4%) underwent thoracoscopic resection. The other 799 (61.2%) underwent thoracotomy: 767 underwent resection, but 32 (2.5%) had an exploratory thoracotomy. Thoracoscopy had suggested unresectability in 7 (0.5%) patients, had been incompletely carried out in 4 (0.3%), and was unfeasible in 21 (1.6%) owing to insurmountable technical reasons. In our previous series from 1980 to 1991 the exploratory thoracotomy rate had been 11.6%. In the present series, after the introduction of routine thoracoscopy in the staging process, the exploratory thoracotomy rate was 2.5%. Thoracoscopy was reliable in excluding unresectability (negative predictive value 0.97). The global percentage of correct staging was significantly better (P <.0001) by thoracoscopy (73.3%) than by computed tomography (48.7%). Considering T descriptor, video-assisted thoracic surgery correctly matched with final pathologic staging in 96.2% of patients. Conclusions: Routine preliminary videothoracoscopy ensured assessment of tumor resectability and feasibility of the resection through thoracoscopy and limited unnecessary thoracotomies.

Original languageEnglish
Pages (from-to)1206-1212
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume138
Issue number5
DOIs
Publication statusPublished - Nov 2009

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Thoracoscopy
Lung Neoplasms
Thoracotomy
Non-Small Cell Lung Carcinoma
Video-Assisted Thoracic Surgery
Neoplasms
Tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Routine surgical videothoracoscopy as the first step of the planned resection for lung cancer. / Vergani, Contardo; Varoli, Federico; Despini, Luca; Harari, Sergio; Mozzi, Enrico; Roviaro, GianCarlo.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 138, No. 5, 11.2009, p. 1206-1212.

Research output: Contribution to journalArticle

Vergani, Contardo ; Varoli, Federico ; Despini, Luca ; Harari, Sergio ; Mozzi, Enrico ; Roviaro, GianCarlo. / Routine surgical videothoracoscopy as the first step of the planned resection for lung cancer. In: Journal of Thoracic and Cardiovascular Surgery. 2009 ; Vol. 138, No. 5. pp. 1206-1212.
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AU - Vergani, Contardo

AU - Varoli, Federico

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AU - Mozzi, Enrico

AU - Roviaro, GianCarlo

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