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Videothoracoscopic lobectomy: first year of experience in a single center


The purpose of this work is to evaluate the feasibility, safety and oncological appropriateness of a completely videothoracoscopic surgical program of major pulmonary resections (VATS-L) in a single center, in its first year of development.


From April 2012 to date, we performed 42 completely thoracoscopic lobectomies (non rib-spreading) with anterior approach to the pulmonary hilum. Clinical stages I were included and T3 or T4 tumors, central tumors, cN1-N2, previous ipsilateral thoracotomy were excluded. Whenever possible, we have obtained a preoperative diagnosis with CT-guided needle biopsy (n = 35, 83%); otherwise lobectomy was preceded by atypical resection and extemporaneous examination. A preoperative mediastinoscopy was performed following the guidelines of the National Comprehensive Cancer Network, 2013 (n = 18, 43%), in the same operative time with extemporaneous examination of the lymph nodes. Lung resection was always associated with a lymphadenectomy of at least 4 ilo-mediastinal stations.


we treated 22 females and 20 males (mean age 71 years, range 54-82) in which we performed: right upper lobectomy n = 10, n = 12, left upper lobectomy, middle lobectomy n = 4, right lower lobectomy n = 9 and left lower lobectomy n = 7. The main number of lymph nodes taken was 5.8 (range: 4-9). In 4 cases (9%) it was necessary to convert the procedure, in 3 cases for minor arterial lesions and in one case for venous injury. The mean operative time was 150 minutes (range 90-270). The histopathologic examination revealed a N1 disease in 5 cases (12%) and in 1 case N2 (2%). The main time of hospitalization was 5 days (range: 3-8). We did not record cases of 30-day mortality.


On the basis of the results of this first year of experience in a single center, VATS-L appears to be a safe and effective alternative to traditional surgery even in the initial phase of a program of development of this technique.

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Correspondence to A Gonfiotti.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Gonfiotti, A., Barale, D., Jaus, M. et al. Videothoracoscopic lobectomy: first year of experience in a single center. J Cardiothorac Surg 8 (Suppl 1), O223 (2013).

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