Video-assisted Thoracoscopic Surgery for Early-stage Non-small Cell Lung Cancer

Traditionally, thoracotomy was the most common thoracic surgical approach before the advent of minimally invasive devices. The malignant lesions can be fully exposed and resected, however, there are major concerns associated with post-operative and severe pulmonary complications and prolonged wound healing. This is largely due to massive surgical trauma and intraoperative loss of blood loss, all of which have been major concerns for both the surgeon and the patient. The initial clinical report on thoracoscopic surgery was published in the 1990s (Lee, 2010). Thereafter, thoracoscopic techniques have become an important surgical approach for thoracic surgery, especially following the advent of video-assisted thoracoscopic surgery (VATS). The advantage of VATS over thoracotomy is that the incision to the patient’s chest is relatively minor, which leads to reductions in post-operative infection and wound dehiscence. This permits the prompt return of the patient to full activity. Therefore, thoracoscopic surgery was gradually adopted for the diagnosis and treatment of lung malignancies complementing the application of endoscopic gastrointestinal anastomat (Endo-GIA). In addition, lobectomy and mediastinal lymph node resection using thoracoscopic devices (Flores, 2010) enables VATS to be one of the most feasible alternatives for early stage lung cancer treatment, an approach which has been widely adopted in developed countries(Yim et al., 1996; Ohbuchi et al., 1998; Roviaro et al., 1998; McKenna, 2006; Onaitis