TY  - JOUR
AU  - Zieliński, Marcin
AU  - Gwozdz, Pawel
AU  - Wilkojc, Michal
AU  - Kosinski, Sylweriusz
AU  - Fryzlewicz, Edward
AU  - Nabialek, Tomasz
AU  - Pankowski, Juliusz
AU  - Kwiatkowski, Robert
PY  - 2018
TI  - Non-intercostal access for video-assisted thoracic surgery— analysis of technical advantages and disadvantages
JF  - Journal of Thoracic Disease; Vol 10, Supplement 32 (November 20, 2018): Journal of Thoracic Disease (Enhanced Recovery: The Evidence Supporting Best Perioperative Care in Thoracic Surgery)
Y2  - 2018
KW  - 
N2  -  Background:  Video-assisted thoracoscopic surgery (VATS) lobectomy has become an accepted method for the treatment of early-stage non-small-cell lung cancer (NSCLC). The standard VATS approach is an intercostal one which is often followed by postoperative pain due to injury of the intercostal nerve. The non-intercostal techniques of VATS include the subxiphoid, transcervical, transdiaphragmatic and transoral procedures.   Methods:  The technical difficulty of operative management of the anatomical structures during VATS anatomical resection are compared for the intercostal, subxiphoid and transcervical approaches.   Results:  Some operative steps have different range of difficulty, which are analyzed in detail.    Conclusions:  The clearest advantages of the non-intercostal approaches include less postoperative pain and superradial bilateral mediastinal lymphadenectomy in case of the transcervical approach. However, the non-intercostal approaches are more technically demanding procedures, which therapeutic role has to be clarified in the future.
UR  - https://jtd.amegroups.org/article/view/24756