Original articleGeneral thoracicThoracoscopic Lobectomy Facilitates the Delivery of Chemotherapy after Resection for Lung Cancer
Section snippets
Patient Selection
A retrospective analysis was performed of 100 consecutive patients with NSCLC who received adjuvant therapy (chemotherapy with or without radiation therapy) after lobectomy at Duke University Medical Center between January 1, 1999 and July 1, 2004. The study received Institutional Review Board approval in November 2005, with individual patient consent being waived. Patients were excluded if they received their adjuvant therapy at an outside institution (n = 22).
The choice of postoperative
Results
All patients received adjuvant chemotherapy, which generally consisted of a platinum-based agent combined with either a taxane or vinca alkaloid. The chemotherapy regimens did not differ significantly between the two groups (Table 1). In addition to chemotherapy, 20 patients (20%) also received adjuvant combination radiation therapy: 13 patients (30%) in the thoracotomy group and 7 (12%) in the thoracoscopy group (p = 0.04). A significantly higher percentage of patients received combination
Comment
Advantages of a thoracoscopic approach to anatomic lung resection include decreased blood loss [20], decreased pain [2, 5, 11, 20], shorter length of hospitalization and chest tube duration [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11], more rapid return to preoperative activity [2, 5, 20], preserved postoperative pulmonary function [21, 22], decreased inflammatory response (which may confer superior immunologic function) [4, 11], and fewer overall complications [3, 6]. These benefits were achieved with
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