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Surgeons Push for Less Invasive Lung Cancer Procedures

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http://www.forbes.com/forbeslife/health ... 06037.html

FRIDAY, June 29 (HealthDay News) - Less invasive lung surgery should become the first option for cancer patients, U.S. experts say.

The procedure, called thoracoscopic lobectomy, "should be considered the standard of care for patients with early-stage lung cancers," Dr. Michael Reed, an assistant professor of surgery at the University of Cincinnati (UC) and a minimally invasive thoracic surgeon at University Hospital, said in a prepared statement. "But few surgeons offer the procedure because it's difficult and requires a lot of additional training."

Only an estimated 10 percent of all lung cancer operations nationwide are minimally invasive procedures. However, these procedures result in faster recovery time and less pain for patients, Reed said.

Thoracoscopic lobectomy is a minimally invasive lung surgery that uses several small incisions instead of a major chest incision that requires rib-spreading. Only a handful of academic medical centers, including UC, are actively training surgeons to perform the procedure.

"The key to implementing this program into our practice was having a dedicated team of extensively trained thoracic surgeons with expertise in both open and minimally invasive, video-guided techniques," Dr. Sandra Starnes said in a prepared statement. "This isn't a procedure you can perform confidently after just a few cases -- mentorship and expertise are key."

The Cincinnati team has trained two cardiothoracic surgery fellows and more than a dozen community thoracic surgeons to perform minimally invasive lung surgery.

To assess how the training program affected the rate of minimally invasive lobectomies at UC, Reed and Starnes conducted a four-year review of surgical cases at University Hospital and the Cincinnati Department of Veterans Affairs Medical Center.

They found that the number of minimally invasive lobectomies performed by UC surgeons has increased by about 57 percent over four years.

Prior to the implementation of the training program, only about 18 percent of lobectomies were performed with minimally invasive procedures. Now, Reed estimated, 75 percent of lobectomies at University Hospital employ minimally invasive techniques.

"We've shown that with a predetermined, step-by-step plan -- guided by a highly experienced minimally invasive thoracic surgeon -- thoracoscopic lobectomy can be integrated safely into thoracic surgical training programs," Reed said.

These findings were to be presented June 29 at the Western Thoracic Surgical Association's annual meeting in Santa Ana Pueblo, N.M.

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