Videothoracoscopic staging and treatment of lung cancer

From November '91 to December '93, 130 pts. affected by lung cancer, were submitted to Videothoracoscopic Operative Staging (V.O.S.) in order to 1) verify the resectability of the lesion 2) rule out any condition of inoperability 3) assess the technical feasibility of videothoracoscopic removal.The patients were subdivided in three groups : Group A) 13 (10%) pts with peripheral tumors (0.5-2.7 cm) with very compromised conditions. They were submitted to videoendoscopic wedge resection. Group B) 68(52%) patientswith lung cancer at I1-111 stage in which videothoracoscopy is performed for staging or for excluding causes of inoperability unrecognisable preoperatively. Operability was confirmed in 57 who were subjected to a traditional thoracotomic intervention. In 11 pts V.O.S. revealed inoperability. In 4 patients videothoracoscopic exploration could not be adequately carried out ,and an open exploration proved necessary. Group C: 49 (38%) pts with lung cancer preoperatively staged T1N0-T2N0. In these patients three videothoracoscopic pneumonectomies and 46 Iobectomies were carried out. Accurate Ioco regional lymphoadenectomy was always accomplished.