Review Article

Video-assisted thoracic surgery in advanced non-small cell lung cancer treatment

Anil Gokce* and Celal Bugra Sezen

Published: 14 August, 2020 | Volume 4 - Issue 2 | Pages: 035-038

Non-small cell lung cancer is one of the leading causes of cancer-related mortality worldwide. Despite recent advances in adjuvant treatments, surgical resection is basis of treatment. With the development of minimally invasive surgery in thoracic surgery, surgeons work on minimally invasive surgery for advanced stages of lung cancer, previously considered non-operable at all or previously considered non-operable with minimally invasive surgery approach.

Minimally invasive surgical techniques which are routinely used in the surgical treatment of early-stage lung cancer have started to be treated in more complicated and advanced stages of lung cancer. Bilateral anatomic resections, operations after neoadjuvant chemotherapy, bronchial sleeve lobectomies, double sleeve lobectomies, complementary pneumonectomies, and carinal sleeve resections can be performed by minimally invasive methods. The option of video-assisted surgery should be considered with oncological principles at foreground if patients have acceptable lung and cardiac performance conditions with minimal comorbidities.

This study reviews VATS experience in patients with advanced-stage lung cancer worldwide and discusses potential benefits and limitations of using VATS technology to perform thoracic surgery procedures.

Read Full Article HTML DOI: 10.29328/journal.ascr.1001050 Cite this Article Read Full Article PDF


Advanced lung cancer; VATS; Minimal invasive surgery



  1. Mazzella A, Olland A, Falcoz PE, Renaud S, Santelmo N, et al. Video-assisted thoracoscopic lobectomy: which is the learning curve of an experienced consultant? J Thorac Dis. 2016; 8: 2444-2453. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059302/
  2. Yao F, Wang J, Yao J, Hang F, Cao S, et al. Video-assisted thoracic surgical lobectomy for lung cancer: description of a learning curve. J Laparoendosc Adv Surg Tech A. 2017; 27: 696-703. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7021397/
  3. Berfield KS, Farjah F, Mulligan MS. Video-assisted thoracoscopic lobectomy for lung cancer. Ann Thorac Surg. 2019; 107: 603-609. PubMed: https://pubmed.ncbi.nlm.nih.gov/30278164/
  4. Mun M, Nakao M, Matsuura Y, Ichinose J, Nakagawa K, et al. Video-assisted thoracoscopic surgery lobectomy for non-small cell lung cancer. Gen Thorac Cardiovasc Surg. 2018; 66: 626-631. PubMed: https://pubmed.ncbi.nlm.nih.gov/30062622/
  5. Wang Z, Pang L, Tang J, Cheng J, Chen N, et al. Video-assisted thoracoscopic surgery versus muscle-sparing thoracotomy for non-small cell lung cancer: a systematic review and meta-analysis. BMC Surg. 2019; 19: 144. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794906/
  6. Bendixen M, Jørgensen OD, Kronborg C, Andersen C, Licht PB. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol. 2016; 17: 836-844. PubMed: https://pubmed.ncbi.nlm.nih.gov/27160473/
  7. Oda R, Okuda K, Osaga S, Watanabe T, Sakane T, et al. Long-term outcomes of video-assisted thoracoscopic surgery lobectomy vs. thoracotomy lobectomy for stage IA non-small cell lung cancer. Surg Today 2019; 49: 369-377. PubMed: https://pubmed.ncbi.nlm.nih.gov/30511319/
  8. Gonzalez-Rivas D, Yang Y, Stupnik T, Sekhniaidze D, Fernandez R, et al. Uniportal video-assisted thoracoscopic bronchovascular, tracheal and carinal sleeve resections. Eur J Cardiothorac Surg. 2016; 49 Suppl 1: i6-16. PubMed: https://pubmed.ncbi.nlm.nih.gov/26609055/
  9. Li J, Wang W, Jiang L, Yin W, Liu J, et al. Video-assisted thoracic surgery resection and reconstruction of carina and trachea for malignant or benign disease in 12 patients: three centers experience in China. Ann Thorac Surg. 2016; 102: 295-303. PubMed: https://pubmed.ncbi.nlm.nih.gov/27112644/
  10. Gonzalez-Rivas D, de la Torre M, Fernandez R, Mosquera VX. Single-port video-assisted thoracoscopic left upper lobectomy. Interact Cardiovasc Thorac Surg. 2011; 13: 539-541.
  11. Sezen CB, Kocatürk CI. Videothoracoscopic lobectomy training in non-small cell lung cancer. Turk J Thorac Cardiovasc Surg. 2019; 27: 199-205. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7021397/
  12. Sezen CB, Bilen S, Kalafat CE, Cansever L, Sonmezoglu Y, et al. Unexpected conversion to thoracotomy during thoracoscopic lobectomy: a single-center analysis. Gen Thorac Cardiovasc Surg. 2019; 67: 969-975. PubMed: https://pubmed.ncbi.nlm.nih.gov/31004316/
  13. Chen K, Wang X, Yang F, Li J, Jiang G, et al. Propensity-matched comparison of video-assisted thoracoscopic with thoracotomy lobectomy for locally advanced non-small cell lung cancer. J Thorac Cardiovasc Surg. 2017; 153: 967-976. PubMed: https://pubmed.ncbi.nlm.nih.gov/28088426/
  14. Augustin F, Maier H, Lucciarini P, Bodner J, Klotzner S, Schmid T. Extended minimally invasive lung resections: VATS bilobectomy, bronchoplasty, and pneumonectomy. Langenbecks Arch Surg. 2016; 401: 341-348.
  15. Nakano T, Endo S, Endo T, Otani S, Tsubochi H, et al. Surgical Outcome of Video-Assisted Thoracoscopic Surgery vs. Thoracotomy for Primary Lung Cancer >5 cm in diameter. Ann Thorac Cardiovasc Surg. 2015; 21: 428-434. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904850/
  16. Hennon M, Sahai RK, Yendamuri S, Tan W, Demmy TL, et al. Safety of thoracoscopic lobectomy in locally advanced lung cancer. Ann Surg Oncol. 2011; 18: 3732-3736.
  17. Gonzalez-Rivas D, Fieira E, Delgado M, Mendez L, Fernandez R, et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis. 2014; 6: 641-648. PubMed: https://pubmed.ncbi.nlm.nih.gov/24976985/
  18. Huang J, Xu X, Chen H, Yin W, Shao W, et al. Feasibility of complete video-assisted thoracoscopic surgery following neoadjuvant therapy for locally advanced non-small cell lung cancer. J Thorac Dis. 2013; 5 Suppl 3: S267-273. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771588/
  19. Matsuoka K, Yamada T, Matsuoka T, Nagai S, Ueda M, et al. Video-assisted thoracoscopic surgery for lung cancer after induction therapy. Asian Cardiovasc Thorac Ann. 2018; 26: 608-614. PubMed: https://pubmed.ncbi.nlm.nih.gov/30249109/
  20. Lyscov A, Obukhova T, Ryabova V, Sekhniaidze D, Zuiev V, et al. Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience. J Thorac Dis. 2016; 8(Suppl 3): S235-241. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783727/
  21. Gao HJ, Jiang ZH, Gong L, Ma K, Ren P, et al. Video-Assisted vs Thoracotomy Sleeve Lobectomy for Lung Cancer: A Propensity Matched Analysis. Ann Thorac Surg. 2019; 108: 1072-1079. PubMed: https://pubmed.ncbi.nlm.nih.gov/31163131/
  22. Fan J, Yao J, Wang Q, Chang Z. Safety and feasibility of uniportal video-assisted thoracoscopic surgery for locally advanced non-small cell lung cancer. J Thorac Dis. 2016; 8: 3543-3550. PubMed: https://pubmed.ncbi.nlm.nih.gov/28149548/


Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?