Video-assisted thoracic surgery lobectomy for stage I lung cancer

Farid - Gharagozloo, Barbara Tempesta, Marc Margolis, E. Pendleton Alexander, Robert J. Mckenna, Todd L. Demmy, Scott Swanson, Thomas M. Egan

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

Background. The technique, safety, and oncologic efficacy of video-assisted thoracic surgery (VATS) lobectomy are controversial. Issues include operative time, lymph node yield, conversion to thoracotomy, resource utilization, recurrence, complications, and survival. Methods. From January 1995 to December 2001, 179 patients underwent VATS lobectomy for preoperative stage I lung cancer (T1N0, 118 patients; T2N0, 61 patients). Mean age was 64.34 years (range, 38 to 87); 91 were female and 88 were male. Contraindications to VATS lobectomy included any suggestion of hilar, endobronchial, or central lesions. Video-assisted thoracic surgery lobectomy was performed using three ports, partial anatomic hilar dissection, and mediastinal node dissection. Results. Distribution of lobectomies was as follows: left upper lobe, 50 patients; left lower lobe, 27 patients; right upper lobe, 33 patients; right upper and right middle lobe, 29 patients; right middle lobe, 9 patients; right lower lobe, 30 patients; right middle lobe and right lower lobe, 1 patient. Mean operative time was 75 ± 6 minutes. Mean lymph node yield was 11 ± 5 nodes. Pathologic upstaging was noted in 14 of the 179 patients (7.8%). Mean hospitalization was 4.1 days (range, 2 days to 4 months). There were no conversions to thoracotomy and there was 1 death (1 of 179, 0.05%). Complications included air leak in 24 of 179 (13.4%), subcutaneous emphysema in 4 of 179 (2.2%), pneumonia in 10 of 179 (5.6%), wound infection in 5 of 179 (2.8%), respiratory failure in 3 of 179 (1.7%), pulmonary embolism in 2 of 179 (1.1%), and myocardial infarction in 1 of 179 (0.5%). At a mean follow-up of 37 months, local recurrence rate was 0.013 per person per year. Actuarial recurrence-free survival was 88% and 85% at 36 and 60 months respectively. Conclusions. For carefully selected patients VATS lobectomy for early stage lung cancer is a safe and effective strategy. Long-term follow-up is required to fully evaluate recurrence and survival.

Original languageEnglish (US)
Pages (from-to)1009-1015
Number of pages7
JournalAnnals of Thoracic Surgery
Volume76
Issue number4
DOIs
StatePublished - Oct 1 2003
Externally publishedYes

Fingerprint

Video-Assisted Thoracic Surgery
Lung Neoplasms
Recurrence
Thoracotomy
Operative Time
Survival
Dissection
Lymph Nodes
Subcutaneous Emphysema
Wound Infection
Pulmonary Embolism
Respiratory Insufficiency
Pneumonia
Hospitalization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Gharagozloo, F. ., Tempesta, B., Margolis, M., Pendleton Alexander, E., Mckenna, R. J., Demmy, T. L., ... Egan, T. M. (2003). Video-assisted thoracic surgery lobectomy for stage I lung cancer. Annals of Thoracic Surgery, 76(4), 1009-1015. https://doi.org/10.1016/S0003-4975(03)00267-4

Video-assisted thoracic surgery lobectomy for stage I lung cancer. / Gharagozloo, Farid -; Tempesta, Barbara; Margolis, Marc; Pendleton Alexander, E.; Mckenna, Robert J.; Demmy, Todd L.; Swanson, Scott; Egan, Thomas M.

In: Annals of Thoracic Surgery, Vol. 76, No. 4, 01.10.2003, p. 1009-1015.

Research output: Contribution to journalArticle

Gharagozloo, F, Tempesta, B, Margolis, M, Pendleton Alexander, E, Mckenna, RJ, Demmy, TL, Swanson, S & Egan, TM 2003, 'Video-assisted thoracic surgery lobectomy for stage I lung cancer', Annals of Thoracic Surgery, vol. 76, no. 4, pp. 1009-1015. https://doi.org/10.1016/S0003-4975(03)00267-4
Gharagozloo F, Tempesta B, Margolis M, Pendleton Alexander E, Mckenna RJ, Demmy TL et al. Video-assisted thoracic surgery lobectomy for stage I lung cancer. Annals of Thoracic Surgery. 2003 Oct 1;76(4):1009-1015. https://doi.org/10.1016/S0003-4975(03)00267-4
Gharagozloo, Farid - ; Tempesta, Barbara ; Margolis, Marc ; Pendleton Alexander, E. ; Mckenna, Robert J. ; Demmy, Todd L. ; Swanson, Scott ; Egan, Thomas M. / Video-assisted thoracic surgery lobectomy for stage I lung cancer. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 4. pp. 1009-1015.
@article{3dde1e788f274ee3bdff889bae0972bc,
title = "Video-assisted thoracic surgery lobectomy for stage I lung cancer",
abstract = "Background. The technique, safety, and oncologic efficacy of video-assisted thoracic surgery (VATS) lobectomy are controversial. Issues include operative time, lymph node yield, conversion to thoracotomy, resource utilization, recurrence, complications, and survival. Methods. From January 1995 to December 2001, 179 patients underwent VATS lobectomy for preoperative stage I lung cancer (T1N0, 118 patients; T2N0, 61 patients). Mean age was 64.34 years (range, 38 to 87); 91 were female and 88 were male. Contraindications to VATS lobectomy included any suggestion of hilar, endobronchial, or central lesions. Video-assisted thoracic surgery lobectomy was performed using three ports, partial anatomic hilar dissection, and mediastinal node dissection. Results. Distribution of lobectomies was as follows: left upper lobe, 50 patients; left lower lobe, 27 patients; right upper lobe, 33 patients; right upper and right middle lobe, 29 patients; right middle lobe, 9 patients; right lower lobe, 30 patients; right middle lobe and right lower lobe, 1 patient. Mean operative time was 75 ± 6 minutes. Mean lymph node yield was 11 ± 5 nodes. Pathologic upstaging was noted in 14 of the 179 patients (7.8{\%}). Mean hospitalization was 4.1 days (range, 2 days to 4 months). There were no conversions to thoracotomy and there was 1 death (1 of 179, 0.05{\%}). Complications included air leak in 24 of 179 (13.4{\%}), subcutaneous emphysema in 4 of 179 (2.2{\%}), pneumonia in 10 of 179 (5.6{\%}), wound infection in 5 of 179 (2.8{\%}), respiratory failure in 3 of 179 (1.7{\%}), pulmonary embolism in 2 of 179 (1.1{\%}), and myocardial infarction in 1 of 179 (0.5{\%}). At a mean follow-up of 37 months, local recurrence rate was 0.013 per person per year. Actuarial recurrence-free survival was 88{\%} and 85{\%} at 36 and 60 months respectively. Conclusions. For carefully selected patients VATS lobectomy for early stage lung cancer is a safe and effective strategy. Long-term follow-up is required to fully evaluate recurrence and survival.",
author = "Gharagozloo, {Farid -} and Barbara Tempesta and Marc Margolis and {Pendleton Alexander}, E. and Mckenna, {Robert J.} and Demmy, {Todd L.} and Scott Swanson and Egan, {Thomas M.}",
year = "2003",
month = "10",
day = "1",
doi = "10.1016/S0003-4975(03)00267-4",
language = "English (US)",
volume = "76",
pages = "1009--1015",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Video-assisted thoracic surgery lobectomy for stage I lung cancer

AU - Gharagozloo, Farid -

AU - Tempesta, Barbara

AU - Margolis, Marc

AU - Pendleton Alexander, E.

AU - Mckenna, Robert J.

AU - Demmy, Todd L.

AU - Swanson, Scott

AU - Egan, Thomas M.

PY - 2003/10/1

Y1 - 2003/10/1

N2 - Background. The technique, safety, and oncologic efficacy of video-assisted thoracic surgery (VATS) lobectomy are controversial. Issues include operative time, lymph node yield, conversion to thoracotomy, resource utilization, recurrence, complications, and survival. Methods. From January 1995 to December 2001, 179 patients underwent VATS lobectomy for preoperative stage I lung cancer (T1N0, 118 patients; T2N0, 61 patients). Mean age was 64.34 years (range, 38 to 87); 91 were female and 88 were male. Contraindications to VATS lobectomy included any suggestion of hilar, endobronchial, or central lesions. Video-assisted thoracic surgery lobectomy was performed using three ports, partial anatomic hilar dissection, and mediastinal node dissection. Results. Distribution of lobectomies was as follows: left upper lobe, 50 patients; left lower lobe, 27 patients; right upper lobe, 33 patients; right upper and right middle lobe, 29 patients; right middle lobe, 9 patients; right lower lobe, 30 patients; right middle lobe and right lower lobe, 1 patient. Mean operative time was 75 ± 6 minutes. Mean lymph node yield was 11 ± 5 nodes. Pathologic upstaging was noted in 14 of the 179 patients (7.8%). Mean hospitalization was 4.1 days (range, 2 days to 4 months). There were no conversions to thoracotomy and there was 1 death (1 of 179, 0.05%). Complications included air leak in 24 of 179 (13.4%), subcutaneous emphysema in 4 of 179 (2.2%), pneumonia in 10 of 179 (5.6%), wound infection in 5 of 179 (2.8%), respiratory failure in 3 of 179 (1.7%), pulmonary embolism in 2 of 179 (1.1%), and myocardial infarction in 1 of 179 (0.5%). At a mean follow-up of 37 months, local recurrence rate was 0.013 per person per year. Actuarial recurrence-free survival was 88% and 85% at 36 and 60 months respectively. Conclusions. For carefully selected patients VATS lobectomy for early stage lung cancer is a safe and effective strategy. Long-term follow-up is required to fully evaluate recurrence and survival.

AB - Background. The technique, safety, and oncologic efficacy of video-assisted thoracic surgery (VATS) lobectomy are controversial. Issues include operative time, lymph node yield, conversion to thoracotomy, resource utilization, recurrence, complications, and survival. Methods. From January 1995 to December 2001, 179 patients underwent VATS lobectomy for preoperative stage I lung cancer (T1N0, 118 patients; T2N0, 61 patients). Mean age was 64.34 years (range, 38 to 87); 91 were female and 88 were male. Contraindications to VATS lobectomy included any suggestion of hilar, endobronchial, or central lesions. Video-assisted thoracic surgery lobectomy was performed using three ports, partial anatomic hilar dissection, and mediastinal node dissection. Results. Distribution of lobectomies was as follows: left upper lobe, 50 patients; left lower lobe, 27 patients; right upper lobe, 33 patients; right upper and right middle lobe, 29 patients; right middle lobe, 9 patients; right lower lobe, 30 patients; right middle lobe and right lower lobe, 1 patient. Mean operative time was 75 ± 6 minutes. Mean lymph node yield was 11 ± 5 nodes. Pathologic upstaging was noted in 14 of the 179 patients (7.8%). Mean hospitalization was 4.1 days (range, 2 days to 4 months). There were no conversions to thoracotomy and there was 1 death (1 of 179, 0.05%). Complications included air leak in 24 of 179 (13.4%), subcutaneous emphysema in 4 of 179 (2.2%), pneumonia in 10 of 179 (5.6%), wound infection in 5 of 179 (2.8%), respiratory failure in 3 of 179 (1.7%), pulmonary embolism in 2 of 179 (1.1%), and myocardial infarction in 1 of 179 (0.5%). At a mean follow-up of 37 months, local recurrence rate was 0.013 per person per year. Actuarial recurrence-free survival was 88% and 85% at 36 and 60 months respectively. Conclusions. For carefully selected patients VATS lobectomy for early stage lung cancer is a safe and effective strategy. Long-term follow-up is required to fully evaluate recurrence and survival.

UR - http://www.scopus.com/inward/record.url?scp=0141563329&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0141563329&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(03)00267-4

DO - 10.1016/S0003-4975(03)00267-4

M3 - Article

C2 - 14529976

AN - SCOPUS:0141563329

VL - 76

SP - 1009

EP - 1015

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -