Video-assisted thoracoscopic surgery (VATS) has without a doubt revolutionized the practice of thoracic surgeons and improved patient experiences and outcomes worldwide. VATS lobectomy represents a true success story, a surgical approach which has matured over the past decades and now accounts for approximately 45% of all lobectomies in the Society of Thoracic Surgeons General Thoracic Database (1,2). The utilization of the VATS technique is increasing rapidly in the US, Asia and Europe, in light of the overwhelming benefits for this approach. In particular, VATS has now become the treatment of choice for patients undergoing pulmonary resections at tertiary referral hospitals, whereas open thoracotomy is reserved for complicated cases.
The expert consensus meeting held in Edinburgh, UK, in November 2012, summarized the major achievements in VATS over the past 20 years and emphasized the need for multi-institutional databases and more dedicated mentoring programs. Given the current success and superior surgical outcomes, the future for VATS is bright. The emphasis is no longer on the issue of VATS versus open thoracotomy, but has shifted towards further refinement of this surgical technique and its usage in complex resections. In December 2013, we will host the first international conference on VATS segmentectomy, where issues on patient selection, preoperative imaging, detailed operative techniques and surgical outcomes will be discussed.
It is our great pleasure to introduce our special Guest Editor, Professor Gaetano Rocco, Director of Department of Thoracic Surgery and Oncology, Chief of Division of Thoracic Surgery, National Cancer Institute, Pascale Foundation, Italy. This issue of the Journal of Thoracic Disease provides a comprehensive overview on VATS with a special emphasis on the uniportal approach. We sincerely thank our collaborators from all over the world who have shared their expertise and contributed diverse and comprehensive knowledge for this excellent issue. On behalf of Professor Gaetano Rocco and our excellent group of knowledgeable contributors, we hope that the practical information provided herein will aid in the implementation of VATS for our patients with lung cancer.
- Cao C, Manganas C, Ang SC, et al. A meta-analysis of unmatched and matched patients comparing video-assisted thoracoscopic lobectomy and conventional open lobectomy. Ann Cardiothorac Surg 2012;1:16-23. [PubMed]
- Ceppa DP, Kosinski AS, Berry MF, et al. Thoracoscopic lobectomy has increasing benefit in patients with poor pulmonary function: a Society of Thoracic Surgeons Database analysis. Ann Surg 2012;256:487-93. [PubMed]
Disclosure: The authors declare no conflict of interest.