Can Minimally Invasive Lung Cancer Surgery Improve Chemotherapy Outcomes?

By Brian Rodane

Minimally invasive lung cancer surgery can be used to remove cancerous tissue without the need to open the patient's chest. A traditional approach to performing a lobectomy required the surgeon to make a long incision into the chest. Then, the chest is opened and the ribs are either spread apart or removed in order to give the surgical team a better view of the affected lobe. The operation usually involves a significant level of postoperative pain as well as a longer recovery time.

Chemotherapy drugs are often administered to the patient after the procedure. This is done to help kill any diseased cells that may have spread to other sites. In most cases, these drugs must either be delayed or the dosage must be reduced until the patient has recovered.

In this article, we'll describe how a lobectomy can be performed without the high-impact trauma associated with conventional thoracotomy. We'll also explain the effect this has on chemotherapy outcomes.

What Is A Thoracoscopic Lobectomy?

A thoracoscopic lobectomy involves the surgeon making a few small incisions between the patient's ribs. A thoracoscope (a tubular instrument) with a small camera attached on the end is inserted through one of the incisions to provide a view of the diseased tissue. Then, additional surgical instruments are inserted through the other incisions to remove the affected lobe and biopsy the chest lymph nodes.

There is no need to open the chest or spread the patient's ribs (as is the case with conventional thoracotomy).

The Aftereffects Of Thoracoscopic Lobectomy

Because this minimally invasive procedure does not require opening the chest, there is less post-op pain, less likelihood of infection, and less impact to the immune system. There is also less chance of the patient developing complications (for example, bleeding) following the operation. As a result, the recovery time is usually shorter than would be the case with open chest surgery.

These factors contribute to the efficacy of chemotherapy drugs. Often, doctors must delay giving the drugs to those who have undergone traditional open surgery due to an impaired immune system. Other times, doctors can administer chemotherapy drugs, but in limited doses.

Because these drugs seek to eliminate cancerous cells that have metastasized, it is important that they are administered as quickly as possible. Delays or limited doses that result from the patient's prolonged recovery time will impact the drugs' effectiveness. This is one of the reasons many surgeons are recommending minimally invasive lung cancer surgery whenever the patient is deemed a good candidate.

In some cases, the minimally invasive techniques that are being used to perform lobectomies can also be used to perform a pneumonectomy (removal of the entire lung). If you have been diagnosed with early stage lung cancer, discuss these options with your doctor. He or she will determine whether you are a good candidate for thoracoscopic resection, lobectomy, or pneumonectomy. - 30285

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