Videoassisted pulmonary resection for lung carcinoma

Major pulmonary resections represent the most difficult operations in videothoracoscopic surgery. since the first lobectomy (1991) other centers around the world have undertaken this experience routinely but technical problems and oncological concerns are the most important limiting factors to the acceptance of these procedures.from May 91 to April 96, 862 videothoracoscopic procedures were performed in our Departement: 133 major pulmonary resections were carried out for lung cancer staged T1N0 or T2N0 with negative bronchoscopy (106 pts -80%), for benign pathologies (22 its -16%), and for lung metastases 5 pts -4%). Indications in lung cancer is still debated due to oncological concerns mainly lymphadenectomy.the number of Lymphnodes removed in the last 80 videolobectomies was compared with the number of nodes removed after conventional lobectomy. Th encumber was comparable ranging from 3 to 7 (mean 10) and being usually greater after videothoracoscopic resection. histology modified the preoperative staging in 18% of cases.the follow up of lung patients ranging from 1 to 55 months is too short to provide any statistic conclusion but in our series we reported no evidence of loco-regional recurrence.