Surgical Outcome of Video-Assisted Thoracoscopic Surgery for Primary Lung Cancer >5 cm in Diameter

Introduction: VATS lobectomy is a safe and feasible procedure for early-stage non-small cell lung cancer. Despite surgical techniques have become refined and surgical instrumentation becomes more advanced, VATS for advanced-stage lung cancer still controversial. We aimed to evaluate the safety, feasibility, and efficacy of videothoracoscopic lobectomy for primary lung cancer with a diameter of >5 cm. Material and Method: We retrospectively reviewed patient characteristics, surgical procedures, perioperative course, pathological findings, and long-term prognoses of 26 patients who underwent videothoracoscopic anatomical pulmonary resection for primary lung cancer of >5-cm diameter. Results: 550 patients underwent a videothoracoscopic lobectomy for treatment of non-small-cell lung cancer at our center from May 2010 to December 2018. In 26 patients, the tumor was > 5 cm. There were 22 men and 4 women, median age 63,0 years (range: 39 – 78 years). Mean duration of lobectomy was 226,35 minutes, and median duration 212,50(range:135-385) minutes. No patient was converted to conventional open thoracotomy. Mean postoperative stay was 6,3 days and mean drainage duration was 5,8 days. The morbidity rate was 30,7%(%15,5 prolonged air leakage, %7,6 posoperative cardiac arrhythmia, %3,8 postoperative hemorrhage and %3,8 postoperative pneumonia). There were no perioperative and intraoperative deaths. Conclusion: Despite some disadvantages of videothoracoscopic surgery for large lung cancer, like less mobilization of the tumor and a reduced operating space, VATS lobectomy is a safe and technically feasible procedure even in for lung cancer of >5-cm diameter in experienced hands.