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Interior Cancer Journal

Video-Assisted Thoracic Surgery Gives Patients a Minimally Invasive Option for Lung Cancer

Removal of malignant lung tissue using video-assisted thoracic surgery (VATS) offers patients who qualify for the procedure a faster and more comfortable recovery. Primarily available only at leading academic hospitals such as Memorial Hermann-Texas Medical Center, VATS for lung cancer is also offered at Memorial Hermann Southeast Hospital.

Philip Rascoe“VATS is an option for most small or peripheral lung tumors,” says Philip A. Rascoe, M.D., FACS, an associate professor in the department of Cardiothoracic and Vascular Surgery at McGovern Medical School at UTHealth. “The standard of care for treatment of lung cancer has long been to remove the lobe that contains the tumor and all potentially affected lymph nodes. Historically, VATS was used to remove a slice of lung for biopsy. With advances in technology and improvements in our skill set, we can now remove lung lobes and perform the lymph node dissection thorascopically, sparing many patients an open thoracotomy.”

VATS employs the same principles of anatomic resection as the open procedure, including individual dissection and ligation of blood vessels and bronchi. “The question has always been whether VATS provides the same long-term outcomes as open thoracotomy,” Dr. Rascoe says. “Recent studies have demonstrated oncological equivalency with regard to resection margins and lymph node dissection, as well as five-year survival rates. We’re basically doing the same operation through smaller incisions.”

VATS allows for removal of a lung cancer-containing lobe through three small incisions – two of 2 centimeters in length (less than an inch), one for the camera and the second for retraction, and a third incision of 5 centimeters in length for removal of the lobe and lymph node dissection. Advantages for the patient are considerable, including less postoperative pain by avoiding the spreading of the ribs required for open thoracotomy; decreased length of hospital stay; faster overall recovery and return to work; and fewer complications, including the need for blood transfusions.

“A percentage of people, about 3 to 5 percent, develop chronic post-thoracotomy pain that persists along the scar line for more than two months following surgery, a condition that is difficult to manage,” Dr. Rascoe says. “In addition to allowing patients to avoid the acute pain associated with open thoracotomy, VATS allows them to avoid post-thoracotomy pain syndrome. We don’t see the same incidence of pain at six months to one year after VATS.”

Dr. Rascoe sees patients in clinic at Memorial Hermann-Texas Medical Center and Memorial Hermann Southeast Hospital. To refer a patient, call 713.486.1144.