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Video-guided lobectomy effective as open surgery against lun


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Video-guided lobectomy effective as open surgery against lung cancer

David Douglas

Reuters Health

Posting Date: October 4, 2004

Last Updated: 2004-10-04 9:17:02 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Long-term survival after videothoracoscopic lobectomy for stage I lung cancer is at least comparable to that achieved after conventional surgery, Italian researchers report in the September issue of Chest.

Dr. Giancarlo Roviaro of the University of Milan and colleagues note that although the video-assisted approach may offer a number of advantages over thoracotomy, it has had limited acceptance.

In fact, Dr. Roviaro told Reuters Health that such "pulmonary resections for cancer are still performed only in a handful of selected specialized centers in the world."

To provide more information on the procedure and its outcomes, the researchers conducted a retrospective review of their own experience.

Over a period of about 10 years, 193 patients with stage I lung cancer underwent the procedure. Survival at 3 years was 77.7% and at 5 years, 63.6%. In patients over the age of 70 years, the corresponding rates were 57.3% and 37.1%. In patients less than 70 years old, survival rates were 82.4% and 72.3%.

There was no statistically significant difference in survival between histologic tumor types, and the researchers say the results match the "best" survival rates seen in the literature following conventional surgery.

The method involves technical difficulties, the investigators concede, but offers advantages including reduced pain, shorter hospital stay and better cosmetic results, as well as reduced tissue damage.

Moreover, Dr. Roviaro continued, "some studies suggest that the minimally invasive approach implies a reduced surgical trauma and a better immunologic response."

"These considerations," he concluded, "should lead the medical community to promote larger trials and further series for initial lung cancer, to validate the procedure, which, once accepted, should be more extensively performed and taught."

Chest 2004;126:725-732.

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Heather , I have posted about this before. Last year I heard a Dr at a thoracic onocology meeting describe how he does it, and watched a video, It is great if you have a doctor who is trained to do this, if the tumor is simple, as not wrapped around something. No broken ribs, small incision, much quicker recovery. Donna G

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