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A Journal on Diseases of the Respiratory System

Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index




Minerva Pneumologica 2010 September;49(3):137-41

language: English

A 14-year experience with thoracoscopic two windows method for lung cancer

Iwazaki M., Inoue H.

Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan


Aim. It has been 14 years since the thoracoscopic two windows method was developed. In this study we assessed 100 cases of stage IA lung cancer cases in which 5 years or more had passed since the procedure was performed.
Methods. Surgery was performed by making small skin incisions in the 4th or 5th intercostal space at 2 sites centered on the inferior angle of the scapula. For right thoracotomy the posterior incision was made 2 cm long, and the anterior incision was 1 cm long, and for left thoracotomy the anterior incision was made 2 cm long, and the posterior incision was 1 cm long. Pulmonary lobectomy and mediastinal lymph node dissection by the thoracoscopic two windows method was performed in consecutive 100 cases of lung cancer with a preoperative or postoperative pathological diagnosis of stage IA, T1N0M0, and perioperative factors were assessed in comparison with 92 cases with a preoperative or postoperative pathological diagnosis of stage IA, T1N0M0 lung cancer in which standard thoracotomy was performed during the same period.
Results. Mean operation time was 2 hours 35 minutes, and mean blood loss was 45.6 mL. The mean number of lymph nodes removed by mediastinal lymph node dissection was 28, and the 5-year survival rate was 78.7% in the standard thoracotomy group and 94.6% in the thoracoscopic surgery group.
Conclusion. Thoracoscopic two windows method is capable of serving as a standard surgical procedure for stage IA lung cancer.

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