ISSN: 2167-0870
Ahmed Abdelaziz Abdellatif*, Akram Allam, Samir Keshk, Abdelmaguid Ramadan, Walid Abuarab, Rita Daniela Marasco, Aniello Della Morte, Gabriella Giudice, Cosimo Lequaglie
Aim: The aim of this study was to evaluate the technical feasibility and limitations of video-assisted mediastinoscopic
lymphadenectomy (VAMLA) followed by video-assisted thoracoscopic surgery (VATS) lobectomy and video-assisted
thoracoscopic surgery (VATS) lobectomy alone in treating patients with non-small cell lung cancer.
VATS lobectomy alone or following VAMLA is feasible and can be done with an acceptable safety profile under the
hands of specialized, highly trained and cooperating team working in a high volume center treating patients with lung
cancer. VAMLA followed by VATS lobectomy allowed the excision of more lymph nodes compared to the VATS
approach alone, suggesting that VAMLA is a good adjuvant to VATS lobectomy for complete radical mediastinal
lymphadenectomy for the surgical cure of non-small cell lung cancer patients.
Over the last decade we witnessed significant change of practice in many thoracic units within the hands of a new
generation of young minimally invasive thoracic Surgeons. The goal of our research was to evaluate the technical
feasibility and limitations of video-assisted mediastinoscopic lymphadenectomy (VAMLA) followed by video-assisted
thoracoscopic surgery (VATS) lobectomy and video-assisted thoracoscopic surgery (VATS) lobectomy alone in treating
patients with non-small cell lung cancer. A prospective study from September 2015 to September 2016 involving 22
non-small cell lung cancer patients admitted to the Department of Thoracic Surgery of the Referral Oncologic
Center of Basilicata (IRCCS-CROB), Italy, was done. Six patients underwent a combination of subsequent VAMLA
and VATS lobectomy (Group A), whereas sixteen patients underwent lobectomy and mediastinal lymphadenectomy
using thoracoscopy only (Group B). Comparison between the two studied groups was done regarding the baseline
characteristics, operative profiles and complications. Males were more than females (17 patients vs. 5 patients)
respectively. The most common tumour was T1 (18 patients). And, the most common encountered tumour was
adenocarcinoma (17 Patients). Our results highlighted that the lobectomy operative time was shorter in (Group A),
(117 minutes) compared to (Group B), (157.5 minutes). The total number of mediastinal lymph nodes excised in
(Group A), (18 lymph nodes) was more than (Group B), (12.5 lymph nodes). VATS lobectomy alone or following
VAMLA is feasible and can be done safely under the hands of specialized, highly trained and cooperating team
working in a high volume center treating lung cancer patients.