1998 Volume 12 Issue 4 Pages 482-487
Thoracoscopic wedge resection was performed for cT1NOMO lung cancer in high-risk patients who were unable to undergo standard thoracotomy. The distance from the pleura to the tumor, as assessed by CT scans, was 2cm or less. The twelve patients studied met one or more of the following criteria : FEV1.0 of less than 800 ml ; ejection fraction of less than 0.3; or age of more than 80 years with poor performance status. Chest tubes were removed at 2 to 10 days after operation (mean, 5.4±3.1 days). Four patients had prolonged air leakage lasting for more than 7 days. Three of these four patients had COPD. No major complications occurred. Patients were discharged at 6 to 19 days after surgery (mean, 12±3.8 days). Actuarial survival at 5 years was 63.7% with a mean follow up of 34 months. Two patients died of recurrent disease (one of local recurrence, one of brain metastasis) and one died of respiratory failure (COPD) 3 years later after surgery. We conclude that thoracoscopic wedge resection is useful for cT1NOMO lung cancer in high-risk patients who were unable to undergo standard thoracotomy.
