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Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection.

Publication ,  Journal Article
Berry, MF; Onaitis, MW; Tong, BC; Balderson, SS; Harpole, DH; D'Amico, TA
Published in: Eur J Cardiothorac Surg
April 2012

OBJECTIVES: Lobectomy with an en-bloc chest wall resection is an effective but potentially morbid treatment of lung cancer invading the chest wall. Minimally invasive approaches to lobectomy have reduced morbidity compared with thoracotomy for early stage lung cancer, but there is insufficient evidence regarding the feasibility of hybrid thoracoscopic lobectomy chest wall resection. We reviewed our experience with an en-bloc chest wall resection and lobectomy to evaluate the outcomes of a hybrid approach using thoracoscopic lobectomy combined with the chest wall resection where rib spreading is avoided. METHODS: All patients who underwent lobectomy and en-bloc chest wall resection with ribs for primary non-small cell lung cancer from January 2000 to July 2010 were reviewed. Starting in April 2003, a hybrid approach was introduced where thoracoscopic techniques were utilized to accomplish the pulmonary resection and a limited counter incision was used to perform the en-bloc resection of the chest wall, avoiding scapular mobilization and rib spreading. Preoperative, perioperative and outcome variables were assessed using the standard descriptive statistics. RESULTS: During the study period, 105 patients underwent en-bloc lobectomy and chest wall resection, including 93 patients with resection via thoracotomy and 12 patients with resection via the hybrid thoracoscopic approach. Complete resection was achieved in all patients in both groups. Tumour size and the extent of resection were similar in the two groups. There were no conversions and no perioperative mortality in the hybrid group. Post-operative outcomes were similar, although patients who underwent the hybrid approach had a shorter length of stay (P = 0.03). CONCLUSIONS: A hybrid approach that combines thoracoscopic lobectomy and chest wall resection is feasible and effective in selected patients. The use of a limited counter incision without rib spreading does not compromise oncologic efficacy. Further experience is needed to determine if this approach provides any advantage in outcomes, including post-operative morbidity.

Duke Scholars

Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

April 2012

Volume

41

Issue

4

Start / End Page

888 / 892

Location

Germany

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Thoracic Wall
  • Thoracic Surgery, Video-Assisted
  • Ribs
  • Retrospective Studies
  • Respiratory System
  • Pneumonectomy
  • Neoplasm Staging
  • Neoplasm Invasiveness
 

Citation

APA
Chicago
ICMJE
MLA
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Berry, M. F., Onaitis, M. W., Tong, B. C., Balderson, S. S., Harpole, D. H., & D’Amico, T. A. (2012). Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection. Eur J Cardiothorac Surg, 41(4), 888–892. https://doi.org/10.1093/ejcts/ezr150
Berry, Mark F., Mark W. Onaitis, Betty C. Tong, Stafford S. Balderson, David H. Harpole, and Thomas A. D’Amico. “Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection.Eur J Cardiothorac Surg 41, no. 4 (April 2012): 888–92. https://doi.org/10.1093/ejcts/ezr150.
Berry MF, Onaitis MW, Tong BC, Balderson SS, Harpole DH, D’Amico TA. Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection. Eur J Cardiothorac Surg. 2012 Apr;41(4):888–92.
Berry, Mark F., et al. “Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection.Eur J Cardiothorac Surg, vol. 41, no. 4, Apr. 2012, pp. 888–92. Pubmed, doi:10.1093/ejcts/ezr150.
Berry MF, Onaitis MW, Tong BC, Balderson SS, Harpole DH, D’Amico TA. Feasibility of hybrid thoracoscopic lobectomy and en-bloc chest wall resection. Eur J Cardiothorac Surg. 2012 Apr;41(4):888–892.
Journal cover image

Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

April 2012

Volume

41

Issue

4

Start / End Page

888 / 892

Location

Germany

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Thoracic Wall
  • Thoracic Surgery, Video-Assisted
  • Ribs
  • Retrospective Studies
  • Respiratory System
  • Pneumonectomy
  • Neoplasm Staging
  • Neoplasm Invasiveness