Video-assisted thoracic surgery (VATS) lobectomy: the initial Swedish experience.

Background: This study was performed to evaluate the technical feasability and validity of video-assisted pulmonary lobectomy using simultaneous stapling of the hilar structures.

Methods: Between December 1995 and July 1997, 30 video-assisted thoracic non-rib spread simultaneously stapled lobectomies (VATS(n)SSL) were performed.

Results: Fourteen males and 16 females underwent 9 right upper, 4 right middle, 5 right lower, 4 left upper, and 8 left lower lobectomies for 15 adenocarcinomas, 7 squamous cell carcinomas, 4 benign and 2 metastatic lesions, 1 carcinoid and 1 mucosa-associated lymphoid tissue-lymphoma. All patients with primary lung carcinoma had peripheral lesions, 13 were T1 and 9 were T2 lesions. Lesions ranged from 1.0 cm to 4.0 cm, averaging 2.2 cm. Results of 10 cervical mediastinoscopies were negative. Two patients had positive nodes at postoperative examination. Operating time for the series averaged 128 minutes, for the first 10 patients 146 minutes, and for the last 10 patients 106 minutes. There was no surgical mortality and no transfusion. Perioperative bleeding averaged 185 mL. Two procedures were converted to open thoracotomy. Hospitalization averaged 4.4 days for the entire group.

Conclusion: Video-assisted thoracic surgical non-rib spread simultaneously stapled lobectomy is a technically feasible and safe procedure. Therapeutic outcomes for resected neoplasms need to be evaluated in long-term follow-up studies.