Abstract

 

OBJECTIVES

This article aims to evaluate the feasibility and safety of a hybrid video-assisted thoracic surgery (VATS) approach to achieve en bloc lobectomy and spinal resection for non-small-cell lung cancer (NSCLC).

METHODS

Between October 2015 and November 2020, 10 patients underwent VATS anatomical lobectomy and en bloc chest wall and spinal resection through a limited posterior midline incision as a single operation for T4 (vertebral involvement) lung cancer. Nine patients had Pancoast syndrome without vascular involvement and 1 patient had NSCLC of the right lower lobe with invasion of T9 and T10.

RESULTS

There were 5 men and 5 women. The mean age was 61 years (range: 47–74 years). Induction treatment was administered to 9 patients (90%). The average operative time was 315.5 min (range: 250–375 min). The average blood loss was 665 ml (range: 100–2500 ml). Spinal resection was hemivertebrectomy in 6 patients and wedge corpectomy in 4 patients. Complete resection (R0) was achieved in all patients. The average hospitalization stay was 14 days (range: 6–50 days). There was no in-hospital mortality. The mean follow-up was 32.3 months (range: 6–66 months). Six patients (60%) are alive without recurrence.

CONCLUSIONS

VATS is feasible and safe to achieve en bloc resection of NSCLC inviding the spine without compromising oncological efficacy. Further experience and longer follow-up are needed to determine if this approach provides any advantages over thoracotomy.

中文翻译：

---

电视胸腔镜联合后正中切口整块切除侵犯脊柱的非小细胞肺癌

摘要

 

目标

本文旨在评估混合电视胸腔镜手术 (VATS) 方法实现非小细胞肺癌 (NSCLC)整块肺叶切除术和脊柱切除术的可行性和安全性。

方法

在 2015 年 10 月至 2020 年 11 月期间，10 名患者接受了 VAT 解剖性肺叶切除术和通过有限的后正中切口整块胸壁和脊柱切除术，作为 T4（椎体受累）肺癌的单一手术。9 例患者患有无血管受累的 Pancoast 综合征，1 例患者患有 T9 和 T10 浸润的右下叶非小细胞肺癌。

结果

有5个男人和5个女人。平均年龄为 61 岁（范围：47-74 岁）。9名患者（90%）接受了诱导治疗。平均手术时间为 315.5 分钟（范围：250-375 分钟）。平均失血量为 665 毫升（范围：100-2500 毫升）。脊柱切除术为 6 例半椎体切除术和 4 例楔形椎体切除术。所有患者均达到完全切除（R0）。平均住院时间为 14 天（范围：6-50 天）。没有住院死亡率。平均随访时间为 32.3 个月（范围：6-66 个月）。六名患者（60%）存活且未复发。

结论

在不影响肿瘤疗效的情况下，VATS 在脊柱内实现整块切除 NSCLC 是可行且安全的。需要进一步的经验和更长的随访时间来确定这种方法是否比开胸术有任何优势。