Featured Research

from universities, journals, and other organizations

Study Shows Minimally Invasive Lung Surgery Has Low Risk With Same Results As Open Surgery

Date:
February 6, 2006
Source:
Cedars-Sinai Medical Center
Summary:
About ninety percent of lung cancer operations at Cedars-Sinai Medical Center are performed using a technique called video-assisted thoracoscopic surgery (VATS). But the minimally invasive procedure is used in only about five percent of cases nationwide. An article in the February 2006 issue of The Annals of Thoracic Surgery, describing the largest published study of the VATS procedure, says the minimally invasive approach accomplishes the same result as open surgery with low risk of complications and very good survival rates.

In the largest published study of its kind, with 1,100 patient cases reviewed, a minimally invasive surgical procedure for lung cancer has been shown to be as effective as open surgery with a low risk of complications and high survival rates when performed by experienced thoracic surgeons.

But even though the benefits of the technique have been documented over the past decade -- shorter recovery times and hospitalizations, reduced pain, and improved quality of life, for example -- it is currently used in only about five percent of the 40,000 lobectomies performed each year in the United States.

An article describing the study appears in the February 2006 issue of The Annals of Thoracic Surgery. It is a follow-up article to one published in the same journal in 1998 that reported on results of video-assisted thoracoscopic surgery (VATS) in 298 patients. Thoracic surgeon Robert McKenna Jr., M.D., surgical director of the Center for Chest Diseases and medical director of Thoracic Surgery and Trauma at Cedars-Sinai, is the principal investigator and senior author.

Instead of making an eight- to 10-inch incision, as is done in a typical thoracotomy, VATS requires only four small incisions through which instruments and a thoracoscope are placed. A camera lens at the tip of the scope feeds high-resolution images to a video monitor, providing the surgeon with a detailed, magnified view of the surgical site. A segment, lobe or entire lung can be removed, depending on the patient's condition and the extent of the cancer.

"At Cedars-Sinai, we now perform 90 percent of our lobectomies by VATS," said McKenna. "This is the highest percentage of major pulmonary resections done by VATS anywhere in the world. Our data show that it can be safe and our long-term follow-up shows that it results in standard cancer survival. Whether you get access through a big hole or a little hole doesn't matter. What matters is survival, and survival is the standard survival that you expect for patients after a lobectomy done for cancer."

Although the size of the incisions may not affect survival, the authors cite a number of recent studies indicating that the minimally invasive approach does result in reduced postoperative pain, better postoperative pulmonary function, and a higher level of patient quality of life. Still, some surgeons have expressed concern about the risk of blood loss with the VATS procedure, as well as the surgeon's ability to deal with any bleeding that should occur, but studies have actually shown the VATS procedure to result in less blood loss, and according to the Annals article, only seven of the 1,100 cases were converted to an open surgery to control bleeding.

McKenna, whose thoracic surgery group may be the most active in the western United States, suggests that one reason the VATS technique has yet to become the standard of practice is that it can be technically challenging for surgeons who are not accustomed to performing videoscopic procedures and those who do not specialize in chest and lung surgery. A thoracic surgeon since 1982, McKenna is a pioneer in the videoscopic technology and technique. Well known for his research and involvement in National Institutes of Health-funded studies, he has performed and written about VATS procedures since 1992.

"Surgeons who do not have the volume of cases to do pulmonary procedures consistently and regularly will have difficulty developing the skills and routine to do lung surgery this way," he said. "But we are seeing an increase in the number of institutions and surgeons who are adopting this approach, and thoracic surgeons from around the world come here to learn how to do their lung operations this way."

Of the 1,100 patients included in the study, 595 were women, 505 were men. The average age was 71 years, with 160 patients being 80 years of age or older. The mortality rate was less than one percent, fewer than five percent of patients needed to go to the intensive care unit, and the median length of hospital stay was three days. All operations were performed between February 1992 and December 2004.

"About 20 percent of our patients go home from the hospital on either the first or second day following lobectomy for lung cancer," McKenna said. "The VATS procedure is not a pain-free surgery. It does hurt; but it does hurt considerably less than standard open procedures. Most patients will be tired and sore for a month or two but VATS tremendously shifts the recovery rate and reduces the pain compared to the standard operation. We have had two patients who played tennis five and six days after having lobectomies this way and two patients who played golf seven days after having lobectomies this way."


Story Source:

The above story is based on materials provided by Cedars-Sinai Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

Cedars-Sinai Medical Center. "Study Shows Minimally Invasive Lung Surgery Has Low Risk With Same Results As Open Surgery." ScienceDaily. ScienceDaily, 6 February 2006. <www.sciencedaily.com/releases/2006/02/060206000329.htm>.
Cedars-Sinai Medical Center. (2006, February 6). Study Shows Minimally Invasive Lung Surgery Has Low Risk With Same Results As Open Surgery. ScienceDaily. Retrieved July 29, 2014 from www.sciencedaily.com/releases/2006/02/060206000329.htm
Cedars-Sinai Medical Center. "Study Shows Minimally Invasive Lung Surgery Has Low Risk With Same Results As Open Surgery." ScienceDaily. www.sciencedaily.com/releases/2006/02/060206000329.htm (accessed July 29, 2014).

Share This




More Health & Medicine News

Tuesday, July 29, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Ebola Virus Threatens West Africa

Deadly Ebola Virus Threatens West Africa

AP (July 28, 2014) West African nations and international health organizations are working to contain the largest Ebola outbreak in history. It's one of the deadliest diseases known to man, but the CDC says it's unlikely to spread in the U.S. (July 28) Video provided by AP
Powered by NewsLook.com
$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Two Americans Contract Ebola in Liberia

Two Americans Contract Ebola in Liberia

Reuters - US Online Video (July 28, 2014) Two American aid workers in Liberia test positive for Ebola while working to combat the deadliest outbreak of the virus ever. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins