Study shows minimally invasive lung surgery has low risk with same results as open surgery

In the largest published study of its kind, with 1,100 patient cases reviewed, a minimally invasive surgical procedure for lung cancer has been shown to be as effective as open surgery with a low risk of complications and high survival rates when performed by experienced thoracic surgeons.

But even though the benefits of the technique have been documented over the past decade shorter recovery times and hospitalizations, reduced pain, and improved quality of life, for example it is currently used in only about five percent of the 40,000 lobectomies performed each year in the United States.

An article describing the study appears in the February 2006 issue of The Annals of Thoracic Surgery. It is a follow-up article to one published in the same journal in 1998 that reported on results of video-assisted thoracoscopic surgery (VATS) in 298 patients. Thoracic surgeon Robert McKenna Jr., M.D., surgical director of the Center for Chest Diseases and medical director of Thoracic Surgery and Trauma at Cedars-Sinai, is the principal investigator and senior author.

Instead of making an eight- to 10-inch incision, as is done in a typical thoracotomy, VATS requires only four small incisions through which instruments and a thoracoscope are placed. A camera lens at the tip of the scope feeds high-resolution images to a video monitor, providing the surgeon with a detailed, magnified view of the surgical site. A segment, lobe or entire lung can be removed, depending on the patient's condition and the extent of the cancer.

"At Cedars-Sinai, we now perform 90 percent of our lobectomies by VATS," said McKenna. "This is the highest percentage of major pulmonary resections done by VATS anywhere in the world. Our data show that it can be safe and our long-term follow-up shows that it results in standard cancer survival. Whether you get access through a big hole or a little hole doesn't matter. What matters is survival, and survival is the standard survival

Contact: Sandy Van
Cedars-Sinai Medical Center

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