J.Jpn. Surg. Soc.. 115(3): 143-146, 2014

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Feature topic

THORACOSCOPIC LOBECTOMY AS MINIMALLY INVASIVE SURGERY

There has always been a conflict between the proposition that surgical methods for treating lung cancer should completely remove the lesion and the seemingly contradictory proposition that they should be as minimally invasive as possible. The achievement of radicality has been pursued by specializing, and began in 1933 when Graham1) 　performed total pneumonectomy for lung cancer. In 1960, the current surgical “gold standard” for lung cancer was reached when anatomical lobectomy and lymph node dissection were performed by Cahan2) 3) , and subsequently called “radical lobectomy.” The pursuit of less invasiveness began in the early 1980s, after the achievement of radicality, and thoracoscopic lobectomy has been developed as a major advance. Thoracoscopic lobectomy differs only in the method of accessing the pleural cavity:the surgical procedure within the pleural cavity does not differ from the procedure for radical lobectomy. In addition, the outcome of patients who have undergone thoracoscopic lobectomy as a form of minimally invasive surgery has been reported to be better than that after open lobectomy, and it is now clear that thoracoscopic lobectomy contributes to improving patients' postoperative quality of life. Accumulating additional cases and further study will be necessary in the future.

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